以奥沙利铂为主联合化疗晚期胃癌的研究

目的比较奥沙利铂、亚叶酸钙及氟尿嘧啶与顺铂、亚叶酸钙及氟尿嘧啶联合化疗对晚期胃癌的疗效和不良反应.方法 108例患者被随机分入两组,A组56例,B组52例.A组：奥沙利铂130 mg/m^2,静脉滴注4小时,第1天;亚叶酸钙200 mg/m^2,静脉滴注2小时,第1～5天;氟尿嘧啶300 mg/m^2,静脉滴注4小时,第1～5天.B组：顺铂80 mg/m^2,静脉滴注2小时,第1天;亚叶酸钙200 mg/m^2,静脉滴注2小时,第1～5天;氟尿嘧啶300 mg/m^2,静脉滴注4小时,第1～5天.3周为1周期,3周期为1疗程.结果 A组有效率60.7%,中位生存时间13.0个月,B组有效率53.8%,中位生存时间11.5个月（P〉0.05）.有效患者的中位缓解期分别是7.8个月和5.5个月,差异有统计学意义（P＜0.05）.A组较B组消化道反应、血液毒性有明显的下降（P＜0.05）.A组中神经毒性出现较多（P＜0.05）.结论奥沙利铂、亚叶酸钙及氟尿嘧啶联合化疗方案治疗晚期胃癌临床疗效肯定,值得进一步研究.

Clinical study of oxaliplatin,fluorouracil and leucovorin regimen in chemotherapy for advanced gastric cancer

Objective To evaluate which is the better regimen in chemotherapy for advanced gastric cancer.Methods One hundred and eight patients with advanced gastric cancer were divided into two groups randomly (group A 56 patients and group B 52 patients).The regimen of the group A was oxaliplatin 130 mg/m~2,iv infusion for 4 hours on day 1; leucovorin 200 mg/m~2,iv infusion for 2 hours followed by 5-fluorouracil 300 mg/m~2,for 4 hours from day 1 to 5.The regimen of the group B was cisiplatin 80 mg/m~2,iv infusion for 2 hours on day 1; LV 200 mg/m~2,iv infusion for 2 hours followed by 5-fluorouracil 300 mg/m~2,for 4 hours from day 1 to 5.All patients finished three cycles (three weeks per cycle).Results The response rate (RR) was (60.7%) in group A and (53.8%) in group B (P>(0.05)); The median survival time was 13 months in group A and (11.5) months in group B (P>(0.05)); The median time to progression was (7.8) months in group A and (5.5) months in group B (P<(0.05)),respectively.The toxicity of vomiting and leukopenia was decreased in group A (P<(0.05)),and the neuro-sensory toxicity was increased in group A (P<(0.05)).Conclusion Oxaliplatin combination 5-fluorouracil/leucovorin yields an encouraging response with acceptable toxicity for advanced gastric cancer,further clinical research is worthwhile.