静脉结合给药的FLEP法治疗难以切除的晚期胃癌

目的:为提高胃癌新辅助化疗的效果,观察动静脉结合的FLEP化疗方法对难以切除局部晚期胃癌的疗效.方法:2003年1月至2006年1月选择30例难以切除的晚期胃癌,以FLEP法化疗.FLEP方案:5-FU 370 mg/(m2·d),持续静脉滴注20h,第1～5天;四氢叶酸钙30mg/(m2·d),静脉滴注,第1～5天;...

Neoadjuvant chemotherapy of FLEP regimen for unresectable local advanced gastric cancer with the combination of intravenous and intra-arterial administration

Objective To improve the results of neoadjuvant chemotherapy for gastric cancer and to observe the efficacy of FLEP regimen for unresectable local advanced gastric cancer with the combination of intravenous and intra-arterial administration.Methods Neoadjuvant chemotherapy was administered in 30 cases of unresectable gastric cancer with advanced abdominal lymph nodes metastases from Jan 2003 to Jan 2006.FLEP regimen consists of continuous intravenous infusion of 5-FU 370 mg/(m2·d) for 20 hours,on day 1-5;leukovorin 30 mg/(m2·d),iv,on day 1-5;epotoside 70 mg/(m2·d) and CDDP 70 mg/(m2·d),ia,on day 6 and 20.After two or three cycles of preoperative chemotherapy,the patients were re-evaluated by CT.All patients were followed up.The median survival time and the 1,2,3 and 5-year survival rate for the whole group were summarized.Results In all 30 patients,5 got stable disease(SD),3 got progression disease(PD),21 got partial response(PR) and 1 got complete response(CR) under CT scan.Excluding SD+PD cases and one patient who rejected the operation,21 patients underwent subtotal or total gastrectomy,even combined organ resection,with D2 or D2+metastatic lymph nodes lymphadenectomy.In this study,the resection rate was 70.0%(21/30),the CT response rate(CR+PR) 73.3%(22/30).The median survival time was 18 months and the 1,2,3 and 5-year survival rate were 76.7%,33.3%,20.0% and 3.3%,respectively.Conclusions The FLEP regimen which combines arterial and venous administration can improve resection rate and survival rate of advanced gastric cancer.