FOLFOX方案同期放疗治疗复发或转移性直肠癌

目的:评价国产奥沙利铂、氟尿嘧啶联合亚叶酸钙(FOLFOX方案)结合同期放射治疗转移性或复发性直肠癌的临床疗效及不良反应。方法:奥沙利铂75 mg/m2静脉滴注,2 h,第1天;氟尿嘧啶300 mg/m2静脉滴注,2~6 h,第1~5天;亚叶酸钙200 mg/m2静脉滴注,2 h,第1~5天,此化疗方案21 d为1周期,治疗3周期。同时进行全盆腔放疗,体外照射DT50~60GY/25~30次(5~6周),所有病例均随访18月。结果:近期疗效完全缓解1例,部分缓解17例,总有效率56.3%。一年生存率为71.9%,2年生存率为46.9%。主要毒副反应是腹泻、消化道反应、放射性直肠炎和神经毒性,而骨髓抑制相对较轻微。结论:国产奥沙利铂为主的联合化疗结合同期放疗治疗复发或转移性直肠癌的效果好,其毒副反应患者可以耐受。

FOLFOX Regimen Combined with Concurrent Radiotherapy for Metastatic or Recurrent Rectal Cancer

objective To evaluate the efficacy of domestic oxaliplatin,fluorouracil and leucovorin(FOLFOX) combined with concurrent radiotherapy in metastatic or recurrent colorectal cancer and the side effects.Methods Chemotherapy regimen:oxaliplatin was intravenously dripped with 75 mg/m2 in 2 hours on the first day,5-Fluorouracil was intravenously dripped with 300 mg/m2 in 2~6 hours from the first day to the fifth day,leucovorin was intravenously dripped with 200 mg/m2 in 2 hours from the first day to the fifth day.The cycle of chemotherapy regimen was 21 days,all the patients received 3 cycles.Concurrent radiotherapy to the whole pelvic area was given in all the cases by irradiating with DT50～60GY/25～30/F for 5～6 weeks,all the cases were followed up for 18 months.Results The recent curative effect was as follows:one case was complete response(CR),17 cases were partial response(PR),the total response rate(CR+PR) was 56.3%.The one year survival rate was 71.9%,and the two year survival rate was 46.9%.The main adverse reaction were diarrhoea,gastrointestinal reaction,radiation proctitis and neurotoxicity,while the incidence of myelosuppression was relatively lower.Conclusion Domestic oxaliplatin,fluorouracil and leucovorin(FOLFOX regimen) combined with concurrent radiotherapy is effective for metastatic or recurrent rectal cancer,and the adverse reaction could be tolerant.