低剂量氟尿嘧啶持续输注联合奥沙利铂治疗老年晚期胃肠道恶性肿瘤.doc

1 低剂量***尿嘧啶持续输注联合奥沙利铂治疗老年晚期胃肠道恶性肿瘤作者:樊卫飞王峻杨民刘福银【摘要】[ 目的] 观察低剂量***尿嘧啶(5-Fu) 持续输注联合奥沙利铂(L-OHP) 方案治疗老年性晚期胃肠道恶性肿瘤的近期疗效及毒副反应等。[ 方法] 32 例晚期胃肠道恶性肿瘤患者给予 5-Fu 225mg/(m2 ·d) 微量泵持续静脉滴注 3周, L-OHP 60mg/m2 d1、8、 15, 静脉滴注, 28d 为1 个周期,2 个周期后评定疗效。[ 结果] CR1 例, PR14 例, NC1 3 例, PD4 例, 32 例病例的总有效率为 %(15/32), 其中转移性肝癌患者有效率为 % ( 11/17 )。化疗后 ECOG 评分比化疗前有显著性改善() 。化疗后毒副反应病人均能耐受。[ 结论] 低剂量***尿嘧啶持续静脉输注联合奥沙利铂方案治疗老年性晚期胃肠道恶性肿瘤是一个有效、低毒, 且能显著改善生活质量的化疗方案。【关键词】药物疗法胃肠肿瘤奥沙利铂 bined Continuous Infusion Fluorouracil with Low-dose and Oxaliplatin in Treatment for Senile Advanced Gastrointestinal Cancer Abstract: [ Purpose ] To evaluate the short? 鄄 term efficacy and toxicities of the continuous central venous infusion () Fluorouracil with low? 鄄 dose and Oxaliplatin in treatment for senile advanced gastrointestinal cancer. [ Methods ] 5?鄄 Fu 225mg/m2 ·d for 3 weeks, and Oxaliplatin 60mg/m2 intravenous drip at d1、8、 15 were administered in 32 patients with advanced gastrointestinal carcinoma. The regimen was repeated every 28 days. The assessment was carried out after two cycles. [ Results ] One patient plete response;14, partial responses; 13, no change; and 4, progressive disease. The overall response rate was %(15/32). The response rate was % (11/17) in patient with liver metastasis. The score of ECOG was significantly improved than that before chemotherapy(). The toxicities of chemotherapy were well tolerated. [ Conclusions ] Combined chemotherapy of continuous infusion 5?鄄 Fu with low? 鄄 dose and Oxaliplatin is an effective, less toxicity regimen which can and improve the quality of life quality in senile advanced 3 gastrointestinal cancer. Key words: drug therapy; gastrointestinal neoplasms; oxaliplatin 近年来,***尿嘧啶(5? 鄄 Fu) 联合醛氢叶酸钙(CF) 、顺铂(DDP) 方案, 已较多地应用于晚期胃肠道恶性肿瘤的治疗, 并取得了较好的客观疗效。但由于顺铂其严重的肾毒性、消化道反应等, 致使老年患者使用受到限制。随着奥沙利铂的问世, 临床上渐用奥沙利铂取代顺铂, 联合***尿嘧啶等治疗晚期胃肠道恶性肿瘤, 结果尤以大肠癌疗效显著[1] , 且毒副反应轻微。我科也于 2001 年8 月至 2005 年6 月间采用低剂量***尿嘧啶持续静脉输注联合周剂量奥沙利铂治疗老年性晚期胃肠道恶性肿瘤 32 例,取得了较好的治疗效果。 1