FOLFOX方案治疗局部进展期或转移性胃癌的疗效分析

目的:观察FOLFOX方案治疗局部进展期或转移性胃癌的疗效、不良反应及安全性。方法:37例局部进展期或转移性胃癌患者均行锁骨下深静脉穿刺或外周肘正中静脉穿刺,置入单腔输液导管,经电脑输液泵控制氟尿嘧啶的输液速度,接受FOLFOX方案化疗(奥沙利铂85 mg/m2,静脉滴注2 h,第1天;亚叶酸钙200 mg/m2,静脉滴注2 h,第1天～第2天;氟尿嘧啶400 mg/m2,静脉滴注,第1天～第2天;氟尿嘧啶600 mg/m2,持续静脉滴注44 h;14 d为1个周期),中位化疗6个周期,4个周期后评价疗效。结果:全组37例均可评价疗效,总有效率为67.6%,其中完全缓解率为27.0%,部分缓解率为40.5%,肿瘤进展时间为9.2个月,中位生存期为13.7个月。在初次化疗的11例患者中,有效率为81.8%;在既往接受过化疗的26例患者中,有效率为61.5%。FOLFOX方案化疗的主要不良反应为血液学毒性、恶心、呕吐和末梢神经感觉异常,多为～度,度不良反应主要包括恶心、呕吐和末梢神经感觉异常。结论:奥沙利铂联合氟尿嘧啶、亚叶酸钙的化疗方案作为辅助性化疗或姑息性化疗用于局部进展期或转移性胃癌均有较好疗效,且毒副反应轻,患者耐受性好。

The analysis of effect on FOLFOX regimen in the patients with locally advanced or metastatic gastric cancer

Objective:To investigate the efficiency,reaction and safety of the FOLFOX regimen in the patients with locally advanced or metastatic gastric cancer.Methods:The biweekly FOLFOX regimen was administered in 37 advanced gastric cancer patients,the patients were treated with FOLFOX regimen:oxaliplatin 85 mg/m2,intravenous drip 2 hours on the first day,calcium folinate 200 mg/m2 intravenous drip 2 hours on the first and second day,5-fluorouracil 400 mg/m2 intravenous drip on on the first and second day,and then continuous infusion of it at a dose of 600 mg/m2 for 44 hours.This regimen was repeated every two weeks.The first evaluation was done after four cycles.The median cycle of the chemotherapy was 6 weeks.Results:The overall response rate(RR)of this series was 67.6%,complete response rate and partial response rate were 27.0% and 40.5%,respectively.The time to progression(TTP)was 9.2 months,and median survival time(MST)was 13.7 months.The RRs of 11 chemotherpy-native patients and 26 patients pre-treated with chemotherpy were 81.8% and 61.5%,respectively.Conclusion:In terms of efficacy and safety,the FOLFOX regimen is effective and well tolerable for patients with locally advanced or metastatic gastric cancers either as adjuvant or palliative chemotherpy.