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目的:比较伊立替康联合奥沙利铂和5-氟尿嘧啶、亚叶酸钙(FOLFOXIRI)与奥沙利铂联合CF,5-FU(FOLFOX4)治疗进展期或转移性胃癌的疗效和毒副反应。方法:经病理确诊的进展期或转移性胃癌患者78人,随机分为两组,FOLFOXIRI组36人,FOLFOX6组42人。FOLFOX4方案:L-OHP 85 mg/m2,第1天静滴,CF 200 mg/m2,5-FU 400 mg/m2,静冲,5-FU 600mg/m2,第1,2天,持续静点22h。FOLFOXIRI方案用法:CPT-11 165 mg/m2,L-OHP,CF,5-FU用法同FOLFOX4。结果:FOL-FOXIRI方案与FOLFOX4方案一线治疗进展期或转移性胃癌的缓解率分别为53.07%和28.57%(P=0.028),中位生存期分别为11.8月和9.4月(P=0.321),中位疾病进展时间为6.0月和4.8月(P=0.036)。FOLFOXIRI方案的骨髓毒性和腹泻发生率高于FOLFOX4方案。结论:本研究结果显示FOLFOXIRI方案治疗胃癌近期缓解率高于FOLFOX4方案,不良反应可以耐受,值得更深入系统地进行临床研究。
OBJECTIVE: To compare the efficacy and side effects of irinotecan with oxaliplatin, 5-fluorouracil, leucovorin (FOLFOXIRI) and oxaliplatin combined with CF and 5-FU (FOLFOX4) in the treatment of advanced or metastatic gastric cancer. Methods: 78 patients with pathologically diagnosed advanced or metastatic gastric cancer were randomly divided into two groups: 36 in FOLFOXIRI group and 42 in FOLFOX6 group. FOLFOX4 regimen: L-OHP 85 mg / m2, intravenous infusion on day 1, CF 200 mg / m2, 5-FU 400 mg / m2, 22h. FOLFOXIRI program usage: CPT-11 165 mg / m2, L-OHP, CF, 5-FU Usage and FOLFOX4. Results: The response rates of FOL-FOXIRI regimen and FOLFOX4 regimen to advanced or metastatic gastric cancer were 53.07% and 28.57% (P = 0.028), respectively. The median survival time was 11.8 months and 9.4 months (P = 0.321) Median disease progression was 6.0 months and 4.8 months (P = 0.036). The incidence of bone marrow toxicity and diarrhea in the FOLFOXIRI regimen was higher than in the FOLFOX4 regimen. Conclusion: The results of this study show that FOLFOXIRI regimen in the treatment of gastric cancer in recent remission rate higher than the FOLFOX4 regimen, adverse reactions can be tolerated, it is worth more in-depth and systematic clinical studies.