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目的评价伊立替康联合氟尿嘧啶双周方案治疗晚期胃腺癌的疗效和不良反应。方法 38例初治的晚期胃腺癌患者,伊立替康150mg/m2静脉滴注第1天,亚叶酸钙200mg/m2静脉滴注第一天,随后氟尿嘧啶2200mg/m2持续微量泵静脉推注46h,14d为一周期。根据实体瘤疗效评价标准对客观缓解率进行评价,不良反应按美国国立癌症研究所制定的通用药物毒性评价标准(第3版)进行评价。结果 35例患者可评价疗效,无完全缓解患者,部分缓解(PR)10例,稳定(SD)8例,进展(PD)17例,总有效率28.6%,疾病控制率51.4%,中位肿瘤进展时间3.2个月,中位生存期8.5个月,1年生存率31.4%。最常见的不良反应为骨髓抑制、呕吐和迟发性腹泻,多为I、Ⅱ级,患者耐受良好。结论伊立替康联合氟尿嘧啶双周方案治疗晚期胃腺癌,具有较好的疗效和安全性,值得临床上进一步试用。
Objective To evaluate the efficacy and adverse reactions of irinotecan combined with 5-fluorouracil in the treatment of advanced gastric adenocarcinoma. Methods 38 cases of newly diagnosed patients with advanced gastric adenocarcinoma, irinotecan 150mg / m2 on the first day of intravenous infusion of leucovorin 200mg / m2 on the first day, followed by fluorouracil 2200mg / m2 continuous micro-pump intravenous injection of 46h, 14d for a cycle. The objective response rate was evaluated according to the evaluation criteria of solid tumor efficacy. Adverse reactions were evaluated according to the General Drug Toxicity Evaluation Criteria (3rd Edition) developed by the National Cancer Institute. Results In 35 patients, there were 10 patients with complete remission (PR), 8 with stable response (SD), 17 with progression (PD), the total effective rate was 28.6% and the disease control rate was 51.4% Duration of 3.2 months, the median survival of 8.5 months, 1 year survival rate of 31.4%. The most common adverse reactions were myelosuppression, vomiting and delayed diarrhea, mostly in grades I and II, and patients were well tolerated. Conclusion The combination of irinotecan and fluorouracil bifunctional regimen in the treatment of advanced gastric adenocarcinoma has good curative effect and safety, which deserves further clinical trial.