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目的:观察5-氟尿嘧啶(5-FU)以及亚叶酸钙(CF)联合奥沙利铂(OXA)、多西他赛(TXT)治疗晚期胃癌的疗效和不良反应。方法:晚期胃癌患者81例,TXT 35~40 mg/m2,静脉滴入1 h,d1、d8;OXA 65 mg/m2,静脉滴入2 h,d1、d8;CF 200 mg/m2,静脉滴入2 h后,5-FU300 mg/m2,静脉推注,1 500 mg/m2持续静脉滴入72 h。21 d为1个周期,每连用2个周期后评价疗效及相关毒性反应。结果:全组80例可评价疗效,总有效率为71.3%(57/80),完全缓解2例,部分缓解55例,中位随访时间12个月,中位无进展生存为5.8个月,中位总生存11.3个月。主要不良反应为骨髓抑制所致的白细胞减少、恶心呕吐、外周神经毒性和腹泻。结论:DOLF方案治疗晚期胃癌近期疗效高,远期可延长患者生存时间,远期生存较理想,毒性反应可以耐受。
Objective: To observe the efficacy and side effects of 5-FU and CF combined with OXA and TXT in the treatment of advanced gastric cancer. Methods: Eighty-one patients with advanced gastric cancer were treated with TXT 35-40 mg / m2 for 1 h, d1, d8, OXA 65 mg / m2, intravenous drip for 2 h, d1, d8 and CF 200 mg / After 2 h, 5-FU 300 mg / m2, intravenous bolus, 1 500 mg / m2 continuous intravenous infusion of 72 h. 21 d for a period of 2 cycles after each evaluation of efficacy and related toxic reactions. Results: In the whole group of 80 cases, the total effective rate was 71.3% (57/80), complete remission in 2 cases, partial remission in 55 cases, median follow-up time in 12 months, median progression-free survival in 5.8 months, The median overall survival was 11.3 months. The main adverse reactions were myelosuppression leukopenia, nausea and vomiting, peripheral neurotoxicity and diarrhea. Conclusion: DOLF regimen is effective in the treatment of advanced gastric cancer in the short term. It can prolong the survival time of patients with long-term, long-term survival is ideal and toxicity can be tolerated.