吉西他滨联合氟尿嘧啶治疗紫杉醇类及顺铂耐药的晚期卵巢癌

目的观察吉西他滨联合氟尿嘧啶(5-FU)治疗对紫杉醇类、顺铂耐药的晚期卵巢癌的疗效和不良反应。方法 2005-02～2011-12用吉西他滨1000 mg/m2,第1、8天;5-FU 300 mg/m2,第1～3天;5-FU 1500 mg/m2微量泵持续72 h静脉滴注,亚叶酸钙(CF)200 mg第1～3天;治疗对紫杉醇类、顺铂耐药的晚期卵巢癌患者36例。结果 36例患者中,CR为19.4%(7例),PR为33.3%(12例),SD为19.4%(7例),PD 27.8%(10例),RR为52.8%,DCR为72.2%。在累计136个疗程中,Ⅲ～Ⅳ度血液学不良反应的发生率为27.2%(37/136)。其中Ⅲ～Ⅳ度中性粒细胞减少症的发生率为21.3%(29/136),Ⅲ～Ⅳ度血小板减少症的发生率为12.5%(17/136),Ⅲ～Ⅳ度贫血的发生率为10.3%(14/136);非血液学不良反应36例的136疗程中,Ⅲ～Ⅳ度消化道反应发生率为30.9%(42/136),口腔溃疡发生率为27.2%(37/136),化疗性肠炎发生率为16.9%(23/136)。结论吉西他滨联合氟尿嘧啶治疗对紫杉醇类、顺铂耐药的晚期卵巢癌有较好的疗效,且不良反应可以耐受。

Clinical research for gemcitabine combined with fluorouracil in the treatment of advanced ovarian cancer patients with taxane and cisplatin resistance

Objective To observe the efficacy and adverse reaction of gemcitabine combined with fluorouracil in the treatment of advanced ovarian cancer patients with taxane and cisplatin resistance.Methods Thirty-six patients who had failures to or relapse after previous treatment were given with taxane and cisplatin as the following regimen: Gemcitabine was administered by intravenous drip at a dose of 1000 mg/m2(on day 1 and day 8),while fluorouracil and calcium folinate were 300 mg/m2(from the first day to the third day) and 200 mg/m2(from the 1st to 3rd day),respectively.Fluorouracil was continuous given intravenously with micro-pumped at 1500 mg/m2 for 72 hours.Results All 36 patients were qualified for efficacy analysis,complete response(CR) was observed in 7 patients(19.4%) and partial response(PR) in 12 patients(33.3%),with an overall response rate of 52.8%;7 cases achieved steady disease(SD) and 10 cases got progression of disease(PD).The rate of grade Ⅲ-Ⅳ haematological adverse reactions was 27.2%,with neutropenia 21.3%,thrombocytopenia 12.5% and anemia 10.3%.In addition,the gastrointestinal tract reaction(30.9%),oral ulcer(27.2%) and chemotherapy enteritis(16.9%) all were the common toxicities.Conclusion Gemcitabine combined with fluorouracil for patients with advanced ovarian cancer who are of resistance to taxane and cisplatin is effective and well tolerated.