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观察小剂量氟尿嘧啶联合顺铂和醛氢叶酸治疗晚期胃癌的近期疗效、临床受益率及毒性反应。方法采用小剂量氟尿嘧啶(350mg/m2)联合顺铂(10mg/d)和醛氢叶酸(50mg/m2)静脉滴入,治疗晚期胃癌36例。根据患者不良反应尽量采取长程用药,全部患者均接受2~6个周期化疗,每个周期5~20d不等。结果全组患者有效率(CR+PR)44.4%,其中CR11.1%,PR33.3%,SD36.1%,PD19.4%。低分化腺癌、管状腺癌、乳头状腺癌、黏液细胞癌有效率分别为22.2%、13.9%、2.8%、0;临床受益率80.6%,食欲好转72.2%,疼痛减轻52.8%,体质量增加30.6%,Karnofsky评分增加>20分为63.9%。不良反应主要为恶心、呕吐、外周静脉炎、口腔溃疡和白细胞减少,多为Ⅰ~Ⅱ度。结论小剂量氟尿嘧啶联合顺铂和醛氢叶酸缓慢静脉滴入是治疗晚期胃癌的一种安全有效的化疗方案。
To observe the short-term efficacy, clinical benefit rate and toxicity of low-dose fluorouracil combined with cisplatin and leucovorin in the treatment of advanced gastric cancer. Methods Low-dose fluorouracil (350mg/m2) combined with cisplatin (10mg/d) and leucovorin (50mg/m2) were infused intravenously to treat 36 cases of advanced gastric cancer. According to the patient’s adverse reactions to take long-term medication as much as possible, all patients received 2 to 6 cycles of chemotherapy, ranging from 5 to 20 days per cycle. Results The effective rate (CR+PR) of the whole group was 44.4%, CR 11.1%, PR 33.3%, SD 36.1%, PD 19.4%. The effective rates of poorly differentiated adenocarcinoma, tubular adenocarcinoma, papillary adenocarcinoma, and mucinous cell carcinoma were 22.2%, 13.9%, 2.8%, 0, respectively; clinical benefit rate was 80.6%, appetite improved 72.2%, pain reduced 52.8%, and body mass With an increase of 30.6%, the Karnofsky score increased by >20 to 63.9%. Adverse reactions were mainly nausea, vomiting, peripheral phlebitis, mouth ulcers and leukopenia, mostly I ~ II degrees. Conclusion The slow intravenous infusion of low-dose fluorouracil combined with cisplatin and aldohydrofolate is a safe and effective chemotherapy for the treatment of advanced gastric cancer.