化疗方案.doc

个体化化疗原则:化疗前取肿瘤组织标本进行MTT等药物敏感试验检测;根据药物敏感试验结果选择化疗方案:药敏药物选择:长春新碱、顺铂、平阳霉素、吡柔比星、阿霉素、表阿霉素、卫猛、长春新碱、抗黑瘤素、5一***尿嘧啶、氨甲蝶呤、强的松、地塞米松、***苄肼、紫杉醇、羟基脲、柔红霉素、卡氮芥、阿糖胞苷、培普利欧。口腔颌面-头颈部鳞癌和腺癌PVP方案适应证:鳞状细胞癌顺铂(cisplatin,CDDP)8O-120mg/m2静滴d1,水化长春新碱(VCR)1--d1221天为一周期,2—3周期为一疗程用药方案:D1AM:5%GNS1OO0ml+10%KCL1Oml/-6hrPM:2O%%GNS500ml+CDDP8O-12Omg/m2/%GNS5OOml+10%KCL1Oml/%甘露醇5Oml/×6林格氏液1000ml/,慢速维持至第二天,如呕吐严重,加KCL1gD2继续补液2OO0ml,如呕吐严重再追加KCL1-2gPYM3mg+NS2Oml/:VCR1-+NS4Oml/:PYM8mg+50%GS500ml/,6hrD4-12PYM8mg+5%GS5Ooml/,6hr病员停止补液后应鼓励多饮水。PVF方案(1)适应症:鳞状细胞癌长春新碱(VCR)1-,d5顺铂8O-12Omg/m2静滴d1(水化)***尿嘧啶(Fluorouracil5-Fu)8OOmg/m2静滴d2-d5用药方案:D1AM:-+NS4Oml/%GNS1000ml+10%KCL1Oml/-6hrPM:2O%甘露醇5Oml/%GNS5Ooml+CDDP1OOmg/m2/%甘露醇5Oml/×65%GNS150Oml+5-Fu8OOmg/m2/-55%GNS2500ml+5-Fu800mg/m2/(24h连续,如呕吐严重,)D5AM:VCR1-+NS40ml/,可重复三个疗程。PVF方案(2)适应症:腺癌、恶性混合瘤、乳头状囊腺癌、腺样囊性癌顺铂SO-120mg/m2,静滴d1,水化长春新碱1-,d8,d155-Fu750mg/m2静滴d3,d9,d16用药方案:W1,D1AM:5%GNS1000ml+1O%KCL1Oml/-6hrPM:20%甘露醇50ml/ivpush5%GNSSOOml+CDDP80-120mg/m2/,2hr5%GNS1000ml+1O%KCL10ml/%甘露醇50ml/×,维持D2VCR1-+NS40ml/%GS2000ml/%GNS5Ooml+5-Fu750mg/m2/%GS2O00ml