摘要
目的 :观察羟基喜树碱、顺铂腹腔灌注与亚叶酸钙、 5 -氟脲嘧啶静脉注射 (LV5FU2 )联合方案治疗晚期胃癌的疗效及毒副反应。方法 :腹腔灌注 :NS2 0 0 0～ 2 5 0 0ml、羟基喜树碱 (HCPT) 10mg/m2 、顺铂 (CDDP)4 0mg/m2 ,d1;全身化疗 :亚叶酸钙 (LV) 2 0 0mg/m2 静脉滴注 2h ,继之静脉推注 5 -氟脲嘧啶 (5 -Fu) 4 0 0mg/m2 ,再以 5 -Fu 6 0 0mg/m2 静脉持续滴注 (civ) 2 2h ,d1 2 。每两周重复 ,行 4周期治疗后判定疗效。结果 :4 1例患者中有 38例完成治疗 ,可评价疗效。可测量病灶 :完全缓解 (CR) 4例 (10 5 % ) ,部分缓解 (PR) 16例(4 2 1% ) ,稳定 (SD) 12例 (31 6 % ) ,进展 (PD) 6例 (15 8% ) ,近期客观有效率 (CR +PR) 5 2 6 % (2 0 / 38)。腹水疗效 :CR6例 (37 5 % ) ,PR7例 (4 3 8% ) ,SD2例 (12 5 % ) ,PD1例 (6 3% ) ,有效率 81 3% (13/ 16 )。 38例均获得随访 ,中位生存期 8个月 ,治疗有效者中位生存期 11个月 ,无效者中位生存期 4个月 ,P <0 0 5。 38例中Ⅲ～Ⅳ度毒副反应 :白细胞下降 5例 (13 2 % ) ,血小板减少 3例 (7 9% ) ,口腔炎 2例 (5 3% ) ,转氨酶升高1例 (2 6 % ) ,恶心、呕吐 4例 (10 5 % ) ,无治疗相关性死亡。结论 :腹腔化疗结合全身化疗治疗晚期胃癌疗效较好 。
Objective:To observe the effects and toxicity of the regimen to patients with advanced/metastatic gastric cancer.Methods:Peritoneal cavity injection:NS 2000～2500ml,HCPT 10mg/m 2,CDDP 40mg/m 2 dl;Vein injection:LV 200mg/m 2 iv 2hr followed by 5-FU 400mg/m 2 iv bolus and 5-FU 600mg/m 2 civ 22hr dl,2.They were repeated every 2 weeeks.Efficacy was evaluated after 4 cycles.Results:Thirty-eight patients finished the study,and were evaluable for clinical response and toxicity.4 patients achieved CR(10.5%),16 PR(42.1%),12 SD(31.6%),6PD(15.8%).ORR(CR+PR)52.6%(20/38).38 patients were paid follow-up visit.Median time to progress was 8 months.There were Grade Ⅲ～Ⅳ WHO toxicity of neutropenia in 5 patients(13.2%),thrombocytopenia in 3 patients(7.9%),stomatitis in 2 patients(5.3%),nausea/vomiting in 4 patients(10.5%).There was no corresponding death during treatment.Conclusion:Chemotherapy of peritoneal cavity combinated with venoclysis is a high response regimen for advanced/metastatic gastric cancer with mild toxicity,which can be practised safely in clinic.
出处
《华西医学》
CAS
2003年第4期503-504,共2页
West China Medical Journal
关键词
腹腔化疗
全身化疗
联合治疗
晚期
胃癌
临床观察
advanced/metastatic gastric cancer
chemotherapy of peritoneal cavity
chemotherapy of venoclysis
cisplatin
calcium folinate
5-Fluorouracil
