论文部分内容阅读
目的观察比较羟基喜树碱联合奥沙利铂方案(HCPTOX)与氟尿嘧啶/亚叶酸钙联合奥沙利铂方案(FOLFOX4)治疗晚期胃癌的临床疗效及毒副反应。方法47例晚期胃癌患者随机分成HCPTOX组与FOLFOX4组。HCPTOX组24例,予羟基喜树碱联合奥沙利铂方案化疗,HCPT 6mg/m2,静脉滴注,第1~5天;奥沙利铂130 mg/m2,静脉点滴,第1天;21 d为1周期。FOLFOX4组23例,予氟尿嘧啶、亚叶酸钙联合奥沙利铂方案化疗,奥沙利铂85 mg/m2,静脉点滴,第1天;亚叶酸钙200 mg/m2,静滴2 h后予氟尿嘧啶400 mg/m2,推注,后续600 mg/m2持续静滴22 h,第1、2天;每2周重复,4周为1周期。两组均治疗2周期以上。按WHO标准评价客观疗效和毒副反应。结果入组47例均可评价疗效,HCPTOX组有效率50.0%,中位TTP 5.8个月,MST10个月;FOLFOX4组有效率47.8%,中位TTP 5.7个月,MST9.8个月。两组近期有效率差异无显著性。毒副反应比较,Ⅲ~Ⅳ级恶心呕吐发生率以FOLFOX4组显著(P<0.05),余毒副反应除腹泻外发生率以FOLFOX4组稍高,但无统计学意义。结论HCPTOX方案与FOLFOX4方案治疗晚期胃癌疗效确切,毒副反应能耐受。两组近期疗效相似,毒副反应以HCPTOX组更易耐受,尤其对一般情况欠佳及老年患者的耐受性好。
Objective To compare the clinical efficacy and toxicity of HCPTOX and Fluorouracil / Leucovorin combined with oxaliplatin (FOLFOX4) in the treatment of advanced gastric cancer. Methods 47 patients with advanced gastric cancer were randomly divided into HCPTOX group and FOLFOX4 group. In the HCPTOX group, 24 cases were treated with HCPT combined with oxaliplatin regimen, HCPT 6 mg / m2, intravenous drip on day 1 to 5, oxaliplatin 130 mg / m2, intravenous drip on day 1, 21 d is 1 cycle. In FOLFOX4 group, 23 patients received fluorouracil and leucovorin combined with oxaliplatin regimen, oxaliplatin 85 mg / m2 intravenously, on day 1, leucovorin 200 mg / m2 and intravenous infusion of fluorouracil 400 mg / m2 bolus followed by 600 mg / m2 intravenously for 22 h on days 1 and 2; repeated every 2 weeks for 4 weeks for 1 cycle. Both groups were treated for more than 2 cycles. According to WHO criteria to evaluate the objective efficacy and toxicity. Results The curative effect was evaluated in 47 cases. The effective rate was 50.0% in HCPTOX group, 5.8 months in median TTP and 10 months in MST. The effective rate in FOLFOX4 group was 47.8%. The median TTP was 5.7 months and MST was 9.8 months. There was no significant difference between the two groups in recent efficiency. The incidence of grade Ⅲ ~ Ⅳ nausea and vomiting was significantly higher in FOLFOX4 group (P <0.05). The incidence of residual side effects except diarrhea was slightly higher in FOLFOX4 group, but it was not statistically significant. Conclusion The HCPTOX regimen and FOLFOX4 regimen are effective in treating advanced gastric cancer and can tolerate toxic and side effects. The two groups of similar efficacy in the near future, toxic side effects to HCPTOX group more easily tolerated, especially for poor general conditions and elderly patients with good tolerance.