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目的观察FOLFOX4化疗方案治疗晚期胃肠道肿瘤的疗效和毒性反应。方法36例晚期胃肠道肿瘤患者,其中胃癌16例,结直肠癌20例。给予奥沙利铂(L-OHP)85mg/m2静脉滴注2h,第1天;亚叶酸钙(CF)200mg/m2静脉滴注,2h,第1、2天;氟尿嘧啶(5-FU)400mg/m2,静脉推注,第1、2天,5-FU600mg/m2微泵持续静脉滴注,22h,第1、2天,2周重复,4周为1个周期。2个周期后以WHO评价标准评价疗效和毒性。结果总有效(CR+PR)率为44.6%,其中胃癌总有效率为37.5%,结直肠癌总有效率50%,两组比较差异无统计学意义(P>0.05),中位缓解时间7.4个月,中位生存期11.4个月,1年生存率为50%。主要毒副反应为急性造血系统,感觉神经毒性和胃肠道反应,对症治疗均能耐受。结论FOLFOX4方案治疗晚期胃肠道肿瘤有提高总生存率的趋势,但远期生存率和后期并发症尚需进一步观察。
Objective To observe the efficacy and toxicity of FOLFOX4 chemotherapy for advanced gastrointestinal cancer. Methods 36 patients with advanced gastrointestinal cancer patients, including 16 cases of gastric cancer, 20 cases of colorectal cancer. (L-OHP) 85mg / m2 intravenous infusion 2h, on the first day; leucovorin (CF) 200mg / m2 intravenous infusion, 2h, on the 1st and 2nd days; fluorouracil (5-FU) / m2, intravenous injection, 1,2 days, 5-FU600mg / m2 micro-pump continuous intravenous infusion, 22h, 1,2 days, 2 weeks repeat, 4 weeks for a cycle. After 2 cycles to evaluate the WHO evaluation of the efficacy and toxicity. Results The total effective rate (CR + PR) was 44.6%. The total effective rate of gastric cancer was 37.5% and the total effective rate of colorectal cancer was 50%. There was no significant difference between the two groups (P> 0.05), and the median effective time was 7.4 Month, the median survival of 11.4 months, 1-year survival rate was 50%. The main side effects of acute hematopoietic system, sensory neurotoxicity and gastrointestinal reactions, symptomatic treatment can tolerate. Conclusion The FOLFOX4 regimen has the tendency to improve the overall survival rate in the treatment of advanced gastrointestinal cancer. However, the long-term survival rate and subsequent complications need to be further observed.