PCF方案和FOLFOX4方案治疗中晚期胃癌的临床观察

摘要

目的 比较紫杉醇联合顺铂及氟尿嘧啶(PCF)化疗方案和奥沙利铂联合亚叶酸钙及氟尿嘧啶(FOLFOX4)化疗方案在中晚期胃癌患者中的有效性、安全性及生存率.方法 收集122例中晚期胃癌患者,其中64例行PCF化疗方案,58例行FOLFOX4化疗方案.PCF方案:紫杉醇 50 mg/m2加入5%葡萄糖注射液500 ml,静脉滴注第1、8、15天;顺铂20 mg/m2,静脉滴注第1～3天;5-氟尿嘧啶750 mg/m2,静脉滴注1 d.FOLFOX4方案:奥沙利铂85 mg/m2,静脉滴注1 d;亚叶酸钙200 mg/m2,静脉滴注1 d; 5-氟尿嘧啶400 mg/m2,静脉滴注1 d;5-氟尿嘧啶600 mg/m2持续静脉滴注泵入维持46 h,2周期后进行临床观察.结果 PCF方案治疗64例,其中完全缓解(CR)2例,部分缓解(PR)29例,病情稳定(SD)24例,病情进展(PD) 9例,总有效率为48.43%;FOLFOX4方案治疗58例,其中CR 2例,PR 25例,SD 19例,PD 12例,总有效率为46.55%.PCF方案治疗的64例患者1年生存率为60.6%,2年生存率为28.9%,中位生存期为16个月;FOLFOX4方案治疗的58例患者1年生存率为53.4%,2年生存率为25.1%,中位生存期为14个月.主要不良反应为血液学毒性、胃肠道反应和末梢神经感觉异常.结论 PCF方案和FOLFOX4方案治疗中晚期胃癌患者疗效相当,生存率相似.%Objective To compare the effect, safety, and survival rate of paclitaxel combined with fluorouracil plus cisplatin ( PCF ), and oxaliplatin combined with fluorouracil puls leucovorin ( FOLFOX4 ) on treating intermediate advanced gastric cancer ( AGC ). Methods One hundred and twenty-two patients with AGC were randomly assigned to receive paclitaxel ( 50 mg/m2 iv ) on days 1 ,8 and 15 , cisplatin( 20 mg/m2 iv ) and fluorouracil ( 750 mg/m2 iv ) on days 1, or oxaliplatin ( 85 mg/m2 iv ) and leucovorin ( 200 mg/m2 iv ) on days 1 , followed by bolus fluorouracil ( 400 mg/m2 iv ) fluorouracil ( 600 mg/m2 iv )on days 1 and 2. After two weeks clinical efficacy was observed. Results 64 patients were treated with PCF and the overall survival rate was 48. 43% . All patients were evaluated for efficacy, and there were 2 cases of complete response, 29 cases of partial response, 24 stable cases, and 9 progressive cases. 1-year survival rate and 2-year survival rate was 60. 6% and 28. 9% and median survival time was 16 months. 58 patients were treated with FOLFOX4 and the overall survival rate was 46. 55% . All patients were evaluated for efficacy, and there were 2 complete responses, 25 partial responses, 19 stable cases, and 12 progressive cases. 1-year survival rate and 2-year survival rate was 53. 4% and 25. 1% and median survival time was 14 months. The side effects were mainly hematological toxicity, gastrointestinal reaction and peripheral sensory neuropathy. Conclusion It is of similar effectiveness and survival rate to AGC treated by PCF and FOLFOX4.