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目的评价奥沙利铂、亚叶酸钙(CF)、氟尿嘧啶(5-FU)组成FOLFOX4方案治疗晚期胃癌的疗效及不良反应。方法采用奥沙利铂联合CF/5-FU组成FOLFOX4方案治疗晚期胃癌45例,方案为奥沙利铂90mg/(m2·d),静脉滴注2h,第1天;CF200mg/(m2·d)静脉滴注2h,第1,2天;5-FU400mg/m2,于CF滴完后静注10min,第1,2天,5-FU600mg/(m2·d),持续泵入48h。每2周重复,4周为1个周期。至少连用2个周期后参加疗效评定。结果45例患者中CR3例(6·7%),PR19例(42.2%),SD17例(37.8%),PD6例(13.3%),总有效率(CR+PR)为48.9%。中位生存期10.5个月,平均生存期11.0个月。较明显的毒副反应为末梢神经炎,其次为口腔粘膜炎、腹泻、恶心、呕吐等。不良反应轻,绝大多数为0-Ⅱ度。结论奥沙利铂与CF/5-FU并用的FOLFOX4双周方案治疗晚期胃癌,有效率高,毒性反应可以耐受,是治疗晚期胃癌,尤其是有心、肝、肾等疾患限制用药的晚期胃癌患者的理想化疗方案,值得进一步应用和研究。
Objective To evaluate the efficacy and adverse reactions of oxaliplatin, calcium folinate (CF) and fluorouracil (5-FU) composition FOLFOX4 regimen in the treatment of advanced gastric cancer. Methods Forty-five patients with advanced gastric cancer were treated with oxaliplatin combined with CF/5-FU FOLFOX4 regimen. The regimen was oxaliplatin 90 mg/(m2·d), intravenous infusion for 2 h, the first day; CF200 mg/(m2·d) ) Intravenous infusion for 2 h, on the 1st and 2nd days; 5-FU 400 mg/m2, intravenously for 10 min after CF drip, on the 1st and 2nd days, 5-FU 600 mg/(m2·d), continuous pumping for 48 h. Repeat every 2 weeks, 4 cycles for 1 cycle. At least 2 consecutive cycles to participate in efficacy assessment. Results Of the 45 patients, 3 were CR (6·7%), 19 were PR (42.2%), 17 were SD (37.8%), 6 were PD (13.3%), and the total effective rate (CR+PR) was 48.9%. The median survival time was 10.5 months and the average survival time was 11.0 months. The more obvious side effects were peripheral neuritis, followed by oral mucositis, diarrhea, nausea, and vomiting. The adverse reactions were mild and most of them were 0-II degrees. Conclusion The combination of oxaliplatin and CF/5-FU combined with FOLFOX4 for the treatment of advanced gastric cancer has high efficiency and tolerable toxicity. It is an advanced gastric cancer for the treatment of advanced gastric cancer, especially those with limitations of heart, liver and kidney. The ideal chemotherapy for patients is worth further study and research.