摘要
背景与目的：目前认为FOLFOX化疗方案[奥沙利铂（oxaliplatin，L-OHP）、氟尿嘧啶（5-fluorouracil，5-FU）、亚叶酸钙（1eucovorin，LV）]可以作为晚期或转移性胃癌的二线方案或援救性方案使用，疗效好且毒副反应可以耐受。而热疗已成为肿瘤综合治疗的有效辅助手段之一，实验研究表明热疗能通过提高DNA复合物形成从而增强L-OHP抗肿瘤疗效。本研究的目的是评价全身热疗联用FOLFOX方案治疗复发或转移性胃癌的近期疗效、不良反应及安全性。方法：试验组21例和对照组18例，既往化疗后出现复发或转移的晚期胃癌患者，采用FOLFOX化疗方案＋全身热疗（whole body hypeahermia，WBH）；[L-OHP135mg／m^3。第一天用；随后用LV200mg／（m^2·d）静滴1h，5-FU按400mg／（m^2·d）联用5天静滴，L-OHP在全身体温达39℃时开始给药，并使体温保持在41．8℃持续1～2h]，治疗2周期后评价疗效，每2l天重复1周期。结果：试验组总缓解率为57．12％；对照组总缓解率22．22％；两组有统计学差异（P〈0．05）；常见的毒副反应为轻度的神经毒性，表现为手指末端麻木感；胃肠道反应及骨髓抑制（白细胞减少）均为轻度，经药物能得到预防和治疗，两组差异无显著性（P〉0．05）。结论：全身热疗联合FOLFOX化疗方案治疗晚期胃癌近期疗效明显，且毒副反应轻患者能耐受。
Background and purpose： The regimen of FOLFOX（L-OHP/LV/5-FU） is regarded as second line or salvage treatments with encouraging response rates and acceptable toxicity in advanced gastric cancer. Hypertberima enhancement of L-OHP efficiency by increased DNA adduct formation has been demonstrated in vitro. To evaluate efficacy, toxicity and feasibility of whole-body hyperthermia （WBH） as an adjunct to L-OHP/LV/5-FU in advanced gastric cancer. Methods： Divided into two groups ： trial group 21 patients and control group 18 patients with advanced gastric cancer , who had progressed after completion of chemotherapy regimen , were treated with L-OHP 135 mg/m^2, 2h intravenous （ i. v. ） infusion, followed by LV 200 mg/m^2/d, lh i.v. infusion, and 5-FU 400mg/ m2/d× 5d infusion. L-OHP （2h infusion） was started at a whole body temperature of 39 degrees C. Whole-body hyperthermia was administered by UHR2000 radiant heat device. The target temperature of 41.8 degrees C was maintained for 1 -2h. They were treated in two periods with 21 days interval. Results： The response rate was 57.12% in trial group, and 22.22% in control group. Which was significant （P 〈0. 05）. The common side effects were symptoms of stomach, nerve toxicity and leucopenia, but these side effects were small WBH treatment combined with FOLFOX regimen showed no unexpected toxicities. WHO grade 3 toxicities were rare. Conclusions： This trial suggests some advantage of combining FOLFOX regimen with WBH. WBH combined with FOLFOX is an active treatment of advanced gastric cancer with acceptable toxicity.
出处
《中国癌症杂志》
CAS
CSCD
2006年第7期581-583,共3页
China Oncology
关键词
胃癌
奥沙利铂
氟尿嘧啶/亚叶酸钙
全身热疗
whole body hyperthermia
Advanced gastric cancer
Oxaliplatin
leucovorin and 5-fluorouracil
