奥沙利铂联合亚叶酸钙及5-氟尿嘧啶治疗晚期大肠癌的临床观察

目的观察奥沙利铂(L-OHP)联合亚叶酸钙(CF)及5-氟尿嘧啶(5-Fu)治疗晚期大肠癌的疗效及不良反应。方法将我院2002年10月~2005年10月收治的65例晚期大肠癌,随机分为A组和B组,A组奥沙利铂130mg/m2静脉滴注2小时,第1天;亚叶酸钙200mg/m2持续静滴24小时,第1~5天;5-氟尿嘧啶500mg/m2持续静滴24小时,第1~5天;每3周重复。B组羟基喜树碱(HCPT)8mg/m2静脉滴注,第1~5天;亚叶酸钙200mg/m2,静脉滴注2小时,第1~5天;5-氟尿嘧啶500mg/m2持续静滴24小时,第1~5天,每3周重复。所有病例均接受2周期化疗。结果A组CR2例,PR12例,SD11例,DD8例,总有效率42.4%,B组CR1例,PR5例,SD16例,PD10例,总有效率18.8%,A组的主要不良反应是周围神经炎及恶心呕吐、骨髓抑制。结论奥沙利铂联合亚叶酸钙及5-氟尿嘧啶疗效优于羟基喜树碱、亚叶酸钙、5-氟尿嘧啶联合化疗,不良反应轻,值得临床推广。

The efficay of L-OHP combined with CF and 5-FU in the treatment of patients with advanced carcinoma of large intestine

Objective:To observe the chemotherapy efficacy and toxicity of L-OHP combined with CF and 5-FU on advanced carcinoma of large intestine. Methods: From 2002~2005 in our hospital,65 patients with advanced carcinoma of large intestine were randomly divided into two groups.Group A:L-OHP 130mg/m2 iv drip(2 hours), d1;CF 200mg/m2 iv drip(2 hours),d1~d5;5-FU 500mg/m2(civ,24hours),d1~d5.The treatment was repedated every 3 weeks for two cycles. Group B:HCPT 8 mg/m2 iv drip,d1~d5; CF 200mg/m2 iv drip(2 hours),d1~d5;5-FU 500mg/m2(civ,24hours) d1~d5,every 3 weeks, for two cycles. Results:Group A CR was achieved in 2 cases,PR 12 casesSD, 11 cases and PD 8 cases .Total response rate was 42.4%. Group B CR was got in 1 case,PR 5 cases ,SD 16 cases and PD 10 cases,total response rate was 18.8%.The main adverse reactions in group A were neurtoxicity,gastrointestinal reaction and bone marrow depression. Conclusion :The chemotherapy efficacy of L-OHP combined with CF and 5-FU is superior to the regiment in group B and the toxicity of it is manageable.It can be used widely in clinical work.