FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效比较

目的:比较FOLFOX4方案和ECF方案治疗老年晚期胃癌的疗效及不良反应.方法:将56例经病理确诊的老年晚期胃癌患者随机分为两组.A组29例,采用FOLFOX4方案化疗:草酸铂75mg/m2 ,静脉滴注2h,d1;亚叶酸钙200mg/m2 ,静脉滴注2h,d1-2;氟尿嘧啶400mg/m2 ,静脉推注,d1、d2 ,氟尿嘧啶600mg/m2 ,持续静脉泵输注22h,d1-2.每2周为1周期.B组27例,采用ECF方案化疗:表柔比星45mg/m2 ,静脉推注,d1;氟尿嘧啶675mg/m2 ,持续静脉泵输注120h;顺铂20mg/m2 ,静脉滴注,d1-3 .每3周为1周期.对两组的近期疗效、疾病进展时间、总生存期、生活质量改善情况、不良反应进行比较.结果:A组和B组的有效率分别为41.4% (12/29)和44.4% (12/27),无显著性差异(P=0.8168).A组和B组的中位疾病进展时间4.6月(1-15月 ),4.8个月(1-14月)(P= 0.8899);中位生存时间7月(2-16月),6.9月(2-16月)(P=0.2905).A组和B 组的生活质量改善为65.5% (19/29)和37.0% (10/27)有显著性差异(P=0.0331);两组主要不良反应白细胞减少、腹泻、口腔炎、神经毒性、脱发、心脏毒性等指标的差异具有显著性(P＜0.05).结论:FOLFOX4方案和ECF方案治疗老年晚期胃癌近期疗效较好,在生活质量改善以及不良反应方面,FOLFOX4方案优于ECF方案,具有更好的耐受性.

Comparison of FOLFOX4 regimen and ECF regimen on advanced gastric carcinoma in elderly patients

Objective:To compare the efficacy and toxicity of FOLFOX4 regimen and ECF regimen on advanced gastric carcinoma(AGG) in elderly patients.Methods:Fifty six patients with AGG were divided into two groups randomly,29 patients in group A treated with FOLFOX4 regimen:L-OHP(75mg/m2 iv 2h d1) were given first,CF(200mg/m2 iv 2h d1-2) followed by 5-FU(400mg/m2 iv d1-2) and 5-FU(600mg/m2 civ 22h d1-2) were given,repeated every 14 days;27 patients in group B treated with ECF regimen:EPI(45mg/m2 iv d1),5-FU(675mg/m2 ci...