摘要
目的回顾性比较FOLFOX以及paclitaxel/LV5Fu2方案治疗晚期胃癌的有效率(RR)、毒副作用、肿瘤进展时间(TTP)及总生存期(OS),寻找晚期胃癌全身化疗的更佳方案。方法选择1999年11月至2005年6月在我院就诊的132例IV期胃癌患者入组。分为A、B两组,两组性别、年龄、病理类型及临床分期资料差异无显著性。A组60例患者使用FOLFOX方案:奥沙利铂85～100 mg/m2,静脉滴注2 h;亚叶酸钙200 mg/m2,静脉滴注2 h,氟尿嘧啶400 mg/m2,静脉推注10 min;氟尿嘧啶2.6 g/m2,静脉灌注48 h;每2周重复1次,每2次为1个疗程。B组72例患者使用紫杉醇75mg/m2,静脉滴注3 h,亚叶酸钙和氟尿嘧啶用量和用法同A组。结果132例患者共化疗544周期,均可评价疗效和毒性反应。A组有效率(RR)35.0%,完全缓解率1.67%;B组有效率为41.7%,完全缓解率5.56%。两组有效率差别无统计学意义(35.0%:41.7%,P>0.05)。A组和B组TTP分别为6.13±1.26月(95%CI,3.65～8.61)和5.92±0.49月(95%CI,4.97～6.87)。A组和B组OS分别为10.67±1.55月(95%CI,7.63～13.71)和10.8±3.07月(95%CI,4.78～16.82)。两组TTP、OS比较无统计学意义(P>0.05)。血液学毒性绝大多数为Ⅰ、Ⅱ度。Ⅲ、Ⅳ度白细胞减少发生率分别为5例(8.33%)和8例(11.11%);Ⅲ、IV度血小板减少发生率分别为1例(1.67%)和2例(2.78%);两组血液学毒性差异无统计学意义。非血液学毒性多数为Ⅰ、Ⅱ度,主要有恶心、呕吐、口腔炎、腹泻、脱发。A组和B组患者的Ⅰ、Ⅱ度脱发分别为15例(25.00%)和42例(58.33%)两组有统计学差异(P<0.05)。A组和B组Ⅰ、Ⅱ度周围神经毒性分别为26例(43.33%)和4例(5.55%);Ⅰ、Ⅱ度周围神经毒性A组明显高于B组,两组差异有统计学意义(P<0.01)。结论对于晚期胃癌患者使用PLF或FOLFOX方案均具有一定的疗效,毒副反应相似,可以耐受,值得临床推广使用。
Objective To compare the efficacy and tolerability of the regimen FOLFOX [leucovorin （LV）, 5-fluorouracil （5-Fu） and oxaliplatin] and the regimen PLF （Paclitaxel, leucovorin and 5-Fu） for treatment of advanced gastric adenocarcinoma. Methods We retrospectively studied the clinical data of 132 patients with stage IV gastric adenocarcinoma treated by FOLFOX （group A, n：60） or PLF （group B, n=72）. The tumor response rate, toxicity, time to progress （TTP） and overall survival （OS） were compared between the two groups. Results A total of 544 cycles were administrated in these patients. The overall response rate was 35.0% with FOLFOX regimen and 41.7% with PLF regimen, showing no significant difference between them （P〉0.05）. The TTP was 6.13±1.26 （95%CI, 3.65-8.61） months in group A, and 5.92±0.49 （95%CI, 4.97-6.87） months in group B; the OS was 10.67±1.55 （95%CI, 7.63-13.71） months in group A, and 10.8±3.07 （95%CI, 4.78-16.82） months in group B. Neither TTP or OS showed significant differences between the two groups （P〉0.05）. Five patients in group A （8.33%） and 8 in group B （11.11%） had grade 3 and 4 leukopenia. The non-hematological toxicities were mostly mild, including nausea, vomiting, stomatitis, diarrhea and alopecia. The main adverse effects were grade l or 2 sensory neuritis in FOLFOX group, and alopecia in PLF group, without significant difference between the two groups （P〈0.05）. Conclusion Both FOLFOX and PLF can serve as effective first-line treatment of stage IV gastric adenocarcinoma with good tolerance.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2008年第9期1599-1602,共4页
Journal of Southern Medical University
基金
广州市科技攻关项目(2006Z3-E0021)
