5-FU加CF双周疗法联合腹腔化疗治疗晚期胃癌临床观察

目的:探讨5-氟尿嘧啶(5-FU) 醛氢叶酸(CF)双周疗法联合顺铂(DDP)、依托泊苷(Vp-16)腹腔化疗治疗晚期胃癌的疗效及不良反应。方法:103例患者按数字随机法分两组。观察组54例:CF200mg/m2,静脉滴入,后经留置中心静脉导管48h持续灌注高浓度5-FU3g/m2,腹腔化疗DDP80mg/m2、Vp-16200mg/m2,每2周重复。对照组49例:CF200mg/d、5-FU500mg/(m2·d),静脉滴入,d1~d5,DDP20mg/(m2·d)、Vp-1670mg/(m2·d),静脉滴入,d1~d4,每3周重复。结果:观察组和对照组有效率分别为64·8%和44·9%,KPS评分增高率分别为74·1%和53·1%,中位生存期分别为13和8·5个月,1年生存率分别为48·1%、38·8%,有效率及KPS评分增高率差异有统计学意义,P<0·05。两组骨髓毒性及消化道反应相似,P>0·05,观察组静脉炎、口腔黏膜炎明显减轻。结论:5-FU CF双周疗法联合腹腔化疗对晚期胃癌有效率高,不良反应较轻,生存质量提高。

Treatment of advanced gastric carcinoma with 5 fluorouracil plus leucovorin biweekly schedule combined with intraperitoneal chemotherapy

OBJECTIVE:To evaluate the efficacy and safety of 5-fluorouracil plus leucovorin biweekly schedule treatment combined with cisplatin,etoposide intraperitoneal chemotherapy on advanced gastric carcinoma.METHODS: A total of 103 cases of advanced gastric carcinoma were randomized into two groups:1) 54 patients in the treatment group of biweekly schedule combined with intraperitoneal chemotherapy: affusing continually high consistency 5-fluorouracil by retained central venous catheter for 48 hours after intravenous dripping leucovorin. Intraperitoneal chemotherapy with cisplatin and etoposide, every 2 weeks repeated; 2) 49 patients in the control group of conventional intravenous chemotherapy: intravenous dripping for five days with 5-fluorouracil plus leucovorin and four days with cisplatin plus etoposide, every 3 weeks repeated. RESULTS: The response rates in the treatment group and the control group were 64.8% and 44.9% respectively. The improvement rates of Karnofsky performance score were 74.1% and 53.1% respectively. The median survival time were 13 months and 8.5 months respectively. The 1-year survival rates were 48.1% and 38.8% respectively. Comparing the rates of response and Karnofsky performance score (P<0.05), there were statistically significant differences. The myelosuppression and alimentary tract reactions were similar, P>0.05.The phlebitis and stomatitis in the treatment group mitigated obviously.CONCLUSIONS: The response rate in the treatment by 5-fluorouracil plus leucovorin biweekly schedule combined with cisplatin and etoposide intraperitoneal chemotherapy is higher to advanced gastric carcinoma. The toxicities were not serious. The quality of the pationts was improved.