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目的观察奥沙利铂(L-OHP)联合5-氟尿嘧啶(5-FU)和亚叶酸钙(CF)治疗胃肠道癌的临床疗效和不良反应。方法本组66例胃肠道癌均经病理证实,其中胃癌29例,结直肠癌37例,行FOLFOX方案化疗:L-OHP150mg/m2+5%GS250mL～500mL静滴2～3h,d1,CF200mg静滴2h后,5-FU250mg静脉推注,随后5-FU600mg/m2静脉持续滴注22h,d1、2、3,每3-4周重复为一个周期。结果完全缓解CR15例,部分缓解PR26例,总有效率62.12%,中位疾病进展时间(MTTP)分别为5.3、6.5个月,中位生存时间分别为10.5、14.6个月。临床获益率分别为75.86%、81.68%。毒副作用主要为骨髓抑制,恶心、呕吐及外周感觉神经异常。结论奥沙利铂联合5-氟尿嘧啶和亚叶酸钙组成的FOLFOX方案治疗胃肠道癌疗效确切,毒副反应轻,用药安全,患者易接受,值得临床推广。
Objective To observe the clinical efficacy and side effects of oxaliplatin (L-OHP) combined with 5-fluorouracil (5-FU) and leucovorin (CF) in the treatment of gastrointestinal cancer. Methods 66 patients with gastrointestinal cancer confirmed by pathology, including 29 cases of gastric cancer, 37 cases of colorectal cancer, FOLFOX chemotherapy: L-OHP150mg / m2 +5% GS250mL ~ 500mL intravenous infusion of 2 ~ 3h, d1, CF200mg After intravenous drip 2h, 5-FU 250mg intravenous injection, followed by 5-FU600mg / m2 intravenous infusion of 22h, d1,2,3, repeated every 3-4 weeks for a cycle. Results The complete remission CR15 cases, partial remission PR26 cases, the total effective rate 62.12%, the median disease progression time (MTTP) were 5.3,6.5 months, the median survival time was 10.5,14.6 months. The clinical benefit rates were 75.86% and 81.68% respectively. The main side effects of bone marrow suppression, nausea, vomiting and peripheral sensory nerve abnormalities. Conclusion FOLFOX regimen consisting of oxaliplatin combined with 5-fluorouracil and leucovorin is effective in treating gastrointestinal cancer. It has the advantages of less toxic and side effects, safe medication and easy acceptance for patients. It is worth to be clinically promoted.