奥沙利铂联合ELF方案治疗晚期胃癌的临床观察

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为了观察奥沙利铂联合ELF(依托泊苷+亚叶酸钙+5-FU)方案治疗晚期胃癌的临床疗效和安全性,选择病理确诊为晚期胃腺癌患者40例,按照奥沙利铂联合ELF方案治疗,奥沙利铂100 mg/m2,静脉滴入2 h,d1;亚叶酸钙200 mg/m2,静脉滴入30 min,d1~d3;5-FU 500 mg/m2,静脉滴入2 h,d1~d3;依托泊苷100 mg/m2,静脉滴入3 h,d1~d3,间隔21 d进行第2个周期化疗,共进行3个周期的治疗,完成第2个周期后评价疗效和不良反应。所有病例均可评价疗效,其中完全缓解(CR)4例,部分缓解(PR)18例,病情稳定(SD)15例,病情进展(PD)3例,总缓解率为55.0%。主要的血液学不良反应为贫血(57.5%)、白细胞减少(40.0%)和血小板减少(47.5%)。最常见的非血液学不良反应有恶心呕吐(52.5%)、口腔黏膜炎(35.0%)、腹泻(42.5%)和脱发(13.5%)。KPS评分提高≥20占42.5%(17/40)。初步研究结果提示,奥沙利铂联合ELF方案治疗进展期胃癌疗效确切,不良反应可以耐受,是值得推广验证的新联合化疗方案。 In order to observe the clinical efficacy and safety of oxaliplatin combined with ELF (etoposide + leucovorin + 5-FU) regimen in the treatment of advanced gastric cancer, 40 patients with pathologically confirmed advanced gastric adenocarcinoma were selected. According to the combination of oxaliplatin and ELF Regimen, oxaliplatin 100 mg / m2, intravenous infusion 2 h, d1; leucovorin 200 mg / m2, intravenous infusion 30 min, d1 ~ d3; h, d1 ~ d3; etoposide 100 mg / m2, intravenous infusion of 3 h, d1 ~ d3, interval 21 d for the second cycle of chemotherapy, a total of three cycles of treatment, the completion of the second cycle after the evaluation of the effect And adverse reactions. All cases were evaluated for efficacy. Among them, 4 were complete remission (CR), 18 were partial remission (PR), 15 were stable disease (SD) and 3 were disease progression (PD). The overall response rate was 55.0%. The major hematologic adverse reactions were anemia (57.5%), leucopenia (40.0%) and thrombocytopenia (47.5%). The most common non-hematologic adverse reactions were nausea and vomiting (52.5%), oral mucositis (35.0%), diarrhea (42.5%) and hair loss (13.5%). KPS score ≥ 20 accounted for 42.5% (17/40). Preliminary results suggest that oxaliplatin combined with ELF regimen for the treatment of advanced gastric cancer is effective and the adverse reactions can be tolerated, which is worthy of promotion and validation of the new combination chemotherapy.
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