奥沙利铂联合表阿霉素、5-氟脲嘧啶、亚叶酸钙治疗晚期胃癌的疗效观察

目的观察奥沙利铂联合表阿霉素、5-氟脲嘧啶、亚叶酸钙治疗晚期胃癌的有效性和安全性。方法全组共42例,入组后给予奥沙利铂(艾恒,江苏恒瑞医药股份有限公司产品)135mg/m2,静滴2小时,第1天,表阿霉素50mg/m2,静注,第1天,亚叶酸钙0.1g静滴,第1～5天,5-氟脲嘧啶500mg/m2,微量泵持续22小时,第1～5天,每3周重复,连用2周期以上后按照WHO实体瘤客观疗效标准评价疗效,按WHO标准判断毒副反应。结果全组共接受了142个周期化疗,平均每例3.38个周期。42例可评价疗效,42例可评价毒副反应。获得CR1例(2.38%),PR22例(52.38%),总有效率(CR+PR)为54.76%。主要毒副作用是消化道反应和骨髓抑制,发生率分别为88.09%和71.43%;外周神经毒性发生率为38.09%,表现为外周感觉神经异常,指(趾)端或口周麻木,以双侧手指最常见,遇冷刺激时加重;未见心肝肾功能损害。结论奥沙利铂联合表阿霉素、5-氟脲嘧啶、亚叶酸钙治疗晚期胃癌有较确切的疗效,并且毒性可以耐受,值得临床进一步应用。

The Clinical Observation of Oxaliplatin for Injection Combined with Epirubicin,5-Fluorouracil and Calcium Folinate in Treating Patients with Advanced Gastric Cancer

Objective To observe the availabitity and the therapy of oxaliplatin for injection combined with epirubicin,5-fluorouracil and calcium folinate in treating patients with advanced gastric cancer.Methods All of 42 patients with advanced gastric cancer in the study were received OCF chemotherapy regimen with 135 mg/m2 of oxaliplatin for injection parenteral solution,intervenous drop 2 hours a day,and epirubicin 50 mg/m2,intravenous a day;calcium folinate 0.1 intervenous drop infusion in 1 ～ 5 days;5-fluorouracil 500 mg/m2,intravenous in graseby to continue 22 hours in 1 ～ 5 days.To evaluate the near-future therapeutic effect according to the WHO standard and to evaluate the toxic reaction according to the WHO standard three weeks later.Results Overall 142 cycles were administrated to the 42 patients (average 3.38 cycles per case).The near-future therapeutic effec could be evaluated for 42 patients,and the toxic reaction could be evaluated for 42 patients.The overall response rate (CR+PR) was 54.76%,the complete remission(CR) was 2.38%,the partial remission (PR) was 52.38%.The common toxic reaction was gastrointestinal reaction and bone marrow depression.Conclusion The therapy of advanced gastric cancer with OCF chemotherapy regimen has indeed better therapeutic effecf,mereover the toxic reaction is tolerant,which deserves further clinical application.