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目的 观察甲酰四氢叶酸钙 (LV)、较小剂量氟尿嘧啶 (5 Fu)与顺铂 (DDP)加羟基喜树碱(HCPT)组成的FDH方案序贯给药 ,治疗中、晚期胃癌的临床疗效。方法 治疗组 2 3例 ,给予FDH方案 ;对照组 30例 ,用 5 Fu、阿霉素 (Ara c)和丝裂霉素组成的FAM方案。两个方案均以时间先后顺序给药。FDH方案为LV 10 0mg/d ,静脉注射 ,30min内滴完 ;5 Fu 5 0 0mg/m2 静脉滴注 ,持续 8h ,第 1～ 5天 ;顺铂 10mg/m2 静脉注射 ,第 1～ 5天 ;HCPT 10mg/m2 静脉滴注 1h ,第 1～ 5天 ;每月为 1个疗程。FAM方案为LV 10 0mg/d ,静脉注射 ,30min内滴完 ;5 Fu 75 0～ 10 0 0mg/m2 静脉滴注第 1～ 5天 ;阿霉素 30mg/m2 静脉注射 ,第 1天 ;丝裂霉素 6mg/m2 静脉注射 ,第 1天 ,每月为 1个疗程。每例至少用完 2个疗程 ,方可评价疗效。结果 FDH组 2 3例中 ,完全缓解 (CR) 1例 ,部分缓解 (PR) 12例 ,稳定 (NC) 6例 ,进展 (PD) 4例 ,有效率为 5 6 .3%。FAM组 30例 ,PR 9例 ,NC 13例 ,PD 8例 ,有效率为 33.3 % ,两组有效率比较 ,差异有显著性 (P <0 .0 5 )。两组主要不良反应均为白细胞减少和胃肠道反应 ,FDH组Ⅲ～Ⅳ度的白细胞下降 (2 1.7% )较FAM组 (4 6 .4% )低 (P <0 .0 5 ) ,未见心、肾、膀胱炎等不良反应。结论 FDH方案治疗中、?
Objective To observe the sequential administration of FDH regimen consisting of formyl tetrahydrofolate (LV), lower dose of fluorouracil (5 Fu) and cisplatin (DDP) plus hydroxycamptothecin (HCPT) for the treatment of advanced gastric cancer. Efficacy. Methods Thirty-three patients in the treatment group were given FDH regimen; 30 patients in the control group were treated with 5 Fu, Ara c, and mitomycin. Both schedules were administered chronologically. The FDH regimen was LV 100 mg/d, intravenously, within 30 minutes; 5 Fu 500 mg/m2 intravenous drip for 8 h, 1 st to 5 days; Cisplatin 10 mg/m 2 intravenously, 1 st to 5 d ; HCPT 10mg/m2 intravenous infusion 1h, the first 1 to 5 days; monthly for a course of treatment. The FAM regimen was LV 100 mg/d, intravenously, and within 30 minutes; 5 Fu 75 0 to 10 0 mg/m2 intravenous drip for 1 to 5 days; doxorubicin 30 mg/m2 intravenously, day 1; silk Intravenous injection of mitomycin 6mg/m2, on the first day, a month for a course of treatment. Only use 2 courses of treatment in each case to evaluate the efficacy. Results Of the 23 patients in the FDH group, 1 had complete remission (CR), 12 had partial remission (PR), 6 had stable (NC), and 4 had progressive (PD). The effective rate was 56.3%. There were 30 cases in FAM group, 9 cases in PR, 13 cases in NC, and 8 cases in PD. The effective rate was 33.3%. There was significant difference between the two groups (P < 0.05). The main adverse events in both groups were neutropenia and gastrointestinal reactions. The FHB group had a decrease in white blood cells at III-IV (2 1.7%) compared with the FAM group (46.4%), but it did not (P < 0.05). See heart, kidney, cystitis and other adverse reactions. Conclusion FDH regimen treatment,