FOLFOX4静脉化疗联合伊立替康腹腔化疗对伴恶性腹腔积液的晚期胃癌患者的疗效研究

目的探讨FOLFOX4静脉化疗联合伊立替康腹腔化疗对伴有恶性腹腔积液的晚期胃癌患者的疗效和安全性。方法对32例伴有中、大量恶性腹腔积液的晚期胃癌患者，先采用FOLFOX4方案静脉化疗，共4～6个周期。同时行腹腔置管引流，尽量放干腹腔积液，然后腹腔内注射药物伊立替康200mg，地塞米松10mg，多巴胺60mg，速尿40mg，1周后重复，共2～4次。观察腹腔积液控制情况及无进展生存期（PFS）。结果全组腹腔积液完全缓解率（cR）为18．8％（6／32），部分缓解率（PR）为46．9％（15／32），腹腔积液控制有效率（RR）为65．6％（21／32）。全组患者无进展生存期（PFS）为5．5个月，总生存期（0S）为9．2个月。主要不良反应是白细胞、血小板下降及消化道反应。结论FOL—FOX4静脉化疗联合伊立替康腹腔化疗对伴有恶性腹腔积液的晚期胃癌患者，具有较好的疗效和安全性。

FOLFOX4 Intravenous Chemotherapy Combined with Irinotecan Intraperitoneal Chemotherapy for Gastric Carcinoma Patients with Malignant Ascites

Objective To evaluate the efficacy and safety of FOLFOX4 intravenous chemotherapy combined with irinotecan intraperitoneal chemotherapy for gastric carcinoma patients with malignant ascites. Methods 32 advanced gastric cancer patients with medium or plentiful malignant ascites received FOLFOX4 regimen first for 4-6 cycles were examined. At the same time,the malignant ascites was emptied with intraperitoneal catheter. The intraperitoneal drugs were irinotecan 200 mg, Dexamethasone 10 mg, dopamine 60 mg. It was repeated in 1 week, 2 -4 times altogether. Ascites control and progression-free survival （PFS） were observed. Results Ascites complete response rate （ CR ） was 18.8% （ 6/32 ）, partial response rate （ PR ） was 46.9% （ 15/32 ）, and ascites control response rate was 65.6% （21/32）. The progression-free survival（PFS） was 5.5 months and overall survival （OS） was 9.2 months. Main toxic reactions were leukocytopenia, thrombocytopenia and gastrointestinal side effects. Conclusion FOLFOX4 intravenous chemotherapy combined with irinotecan intraperitoneal chemotherapy is feasible and effective for gastric carcinoma patients with malignant ascites.