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目的:探讨EAP/LF交替方案治疗进展期胃癌的疗效。方法:自1994年10月至1999年12月,124例经病理确诊的有可测量病灶的进展期胃癌患者被随机分入EAP/LF组(研究组)和EAP组(对照组),研究组用药为:足叶乙甙(Vp-16)70mg/m2,静滴,d4-6;阿霉素(ADM)15mg/m2,静注,d1,7;顺铂(DDP)20mg/m2,静滴,d2,8;醛氢叶酸(CF)70mg/m2,静滴,d29-33;5-氟尿嘧啶(5-FU)325mg/m2,静滴,d29-33;每8周重复。对照组用药为:Vp-1670mg/m2,静滴,d4-6,d25-27;ADM15mg/m2,静注,d1,7,22,28;DDP30mg/m2,静滴,d2,8,23,29;每8周重复。结果:研究组客观有效率为62.1%,明显优于对照组的48.3%(P=0.032);研究组有效者中位生存期、无进展生存时间分别为20个月、13个月,均明显优于对照组的13个月(P=0.037)、7个月(P=0.007)。两组不良反应主要有白细胞减少、口腔粘膜炎、脱发。结论:调整剂量的EAP/LF交替方案是一疗效确切、安全、对生存有益处的治疗进展期胃癌的优势方案,值得临床进一步研究。
Objective: To investigate the efficacy of alternating EAP/LF regimen in the treatment of advanced gastric cancer. METHODS: From October 1994 to December 1999, 124 patients with advanced gastric cancer with pathologically confirmed measurable lesions were randomized into the EAP/LF group (study group) and the EAP group (control group). The use of the drug is: Acetochlor (Vp-16) 70mg/m2, intravenous infusion, d4-6; Adriamycin (ADM) 15mg/m2, intravenous, d1, 7; Cisplatin (DDP) 20mg/m2, static Dri, d2, 8; Aldehydnilic acid (CF) 70 mg/m2, Intravenous, d29-33; 5-Fluorouracil (5-FU) 325 mg/m2, Intravenous, d29-33; Repeated every 8 weeks. The control group used drugs: Vp-1670mg/m2, intravenous infusion, d4-6, d25-27; ADM15mg/m2, intravenous, d1,7,22,28; DDP30mg/m2, intravenous infusion, d2,8,23, 29; Repeat every 8 weeks. Results: The objective and effective rate of the study group was 62.1%, which was significantly better than 48.3% of the control group (P=0.032). The median survival and progression-free survival time of the study group were 20 months and 13 months, respectively. It was better than the control group for 13 months (P=0.037) and 7 months (P=0.007). The main adverse reactions in the two groups were leucopenia, oral mucositis, and hair loss. Conclusion: The dose-adjusted EAP/LF alternative regimen is a superior regimen for the treatment of advanced gastric cancer with definite curative effect, safety and survival benefits. It is worthy of further clinical study.