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目的 通过低剂量氟脲嘧啶（５ＦＵ） 持续输注与叶酸片口服联合羟基喜树碱方案治疗，提高晚期胃癌临床疗效。方法 根据５ＦＵ的剂量和用法分为二组。低剂量组：５ＦＵ２５０ｍｇ／ｍ２／ｄ 持续输注２４ 小时加叶酸片２０ｍｇ／ｍ２／ｄ，羟基喜树碱（ＨＣＰＴ）３０ｍｇ／ｍ２／ｄ１ ，８ ；高剂量组：５ＦＵ５００ｍｇ／ｍ２／ｄ 持续１２０ 小时，ＣＦ２００ｍｇ／ｍ２／ｄ１ ～５天。结果 低剂量组有效率为７５％ ，部分缓解１２ 例。高剂量组有效率为４３．３ ％ ，部分缓解１３ 例。低剂量组以消化道粘膜反应为主要表现；高剂量组以外周静脉炎为主要表现，Ⅱ～Ⅲ度白细胞下降率高于低剂量组。结论 低剂量５ＦＵ持续输注与叶酸片口服联合ＨＣＰＴ方案治疗晚期胃癌的疗效优于高剂量５ＦＵ加ＣＦ方案（ Ｐ＜ ０．０５） 。毒副反应能耐受，值得临床进一步研究。
Objective To improve the clinical efficacy of advanced gastric cancer by continuous infusion of low-dose fluorouracil (5 FU) and oral administration of folic acid tablets combined with hydroxycamptothecin. Methods According to the dose and usage of 5-FU, it was divided into two groups. Low-dose group: 5FU 250mg/m2/d continuous infusion with folic acid tablets 20mg/m2/d, HCPT 30mg/m2/d1, 8; high dose group: 5FU 500mg/m2/ d For 120 hours, CF200mg/m2/d1 to 5 days. Results The effective rate of low-dose group was 75%, and partial remission was 12 cases. The effective rate in the high-dose group was 43.3%, with partial remission in 13 cases. In the low-dose group, the gastrointestinal mucosal reaction was the main manifestation; peripheral phlebitis was the main manifestation in the high-dose group, and the rate of leukocyte decline in the II-III degree was higher than that in the low-dose group. Conclusions The efficacy of low-dose 5FU continuous infusion and folic acid tablets combined with HCPT regimen in the treatment of advanced gastric cancer is superior to that of high-dose 5FU plus CF regimen (P<0.05). Toxic side effects can tolerate and deserve further clinical study.