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[目的]观察奥沙利铂(Oxaliplatin,OXA)联合5鄄氟尿嘧啶(5鄄Fu)及亚叶酸钙(CF)不同给药途径治疗对顺铂(DDP)或卡铂(CBP)耐药肿瘤的近期疗效及不良反应。[方法]选择对DDP或CBP耐药的肿瘤73例,随机分为A、B两组,其中A组36例,OXA100mg/m2,第1天经动脉灌注,5鄄Fu每天600mg/m2,CF每天200mg/m2,第1天经动脉灌注,第2~5天经中央静脉持续滴注(CF2小时滴完,推注5鄄Fu200mg/m2,后继以5鄄Fu400mg/m2持续22小时滴注),每21天为1个周期;B组37例,药物经中央静脉持续滴注,药物、剂量及用药天数同A组。[结果]化疗第6个周期末,A组PR20例,SD8例,PD8例,有效率为55.6%;B组PR7例,SD15例,PD15例,有效率为19.0%。两组的有效率比较有统计学差异(P<0.01)。A组的肿瘤控制率(OTGCR,CR+PR+SD)为77.8%,B组为59.5%,两组比较无统计学差异(P>0.05)。结、直肠癌盆腔或肝转移的有效率分别达44.4%和45.0%,胃癌肝转移的有效率33.3%,肺癌有效率25.0%,胰腺癌肝转移有效率25.0%,胆囊癌肝转移无效。A组的不良反应除手足麻木明显少于B组外,其它不良反应无差别。[结论]OXA联合5鄄Fu、CF治疗对DDP或CBP耐药的部分肿瘤有效,不良反应轻。经动脉用药较经静脉用药明显提高近期缓解率,且可以减少外周感觉神经异常的发生。
[Objective] To observe the effects of oxaliplatin (OXA) combined with 5-fluorouracil (5-Fu) and leucovorin (CF) on the drug resistance to cisplatin (DDP) Recent effects and adverse reactions. [Methods] Totally 73 patients resistant to DDP or CBP were randomly divided into A and B groups, including 36 cases in group A, OXA100mg / m2, arterial infusion on day 1, 600mg / m2 per day for 5 Juan, CF Day 200mg / m2, the first day of arterial perfusion, 2 to 5 days by continuous infusion of the central vein (CF2 hours drops, 5 Juan injection of 200mg / m2, followed by 5 Juan Fu 400mg / m2 sustained infusion of 22 hours) , Every 21 days for a cycle; B group 37 cases, continuous infusion of drugs through the central vein, drug, dose and medication days with the A group. [Results] At the end of the 6th cycle of chemotherapy, there were PR20 cases, SD8 cases and PD8 cases in group A, with an effective rate of 55.6%. Group B had PR7 cases, SD15 cases and PD15 cases with an effective rate of 19.0%. The two groups were statistically significant (P <0.01). The tumor control rate (OTGCR, CR + PR + SD) in group A was 77.8% and in group B was 59.5%. There was no significant difference between the two groups (P> 0.05). The effective rate of pelvic or hepatic metastasis of colorectal cancer was 44.4% and 45.0% respectively, the effective rate of liver metastasis of gastric cancer was 33.3%, the effective rate of lung cancer was 25.0%, the effective rate of hepatic metastasis of pancreatic cancer was 25.0% and the liver metastasis of gallbladder cancer was ineffective. A group of adverse reactions in addition to foot numbness was significantly less than group B, the other adverse reactions no difference. [Conclusion] OXA combined with 5-Fu and CF is effective in treating partial tumors resistant to DDP or CBP with mild adverse reactions. Arterial drugs than intravenous medication significantly improve the rate of recent remission, and can reduce the occurrence of peripheral sensory nerve abnormalities.