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目的评价奥沙利铂(OXA)联合甲酰四氢叶酸钙(LV)和氟尿嘧啶(5-FU)新辅助化疗方案(OXA-LV5FU2)治疗进展期胃癌的疗效与毒副作用。方法27例进展期胃癌患者接受OXA-LVSFU2治疗：OXA 100 mg/m~2,静脉滴注2 h,第1天；LV 200 mg/m~2,静脉滴注2 h后推注5-FU 400 mg/m~2,后续5-FU 1g/m~2以麻醉镇痛泵持续48-72 h恒速静脉输入,第1、2天。每2-3周为1个疗程,共3～4个疗程。观察新辅助化疗后肿瘤原发病灶的缓解情况及其不良反应。结果新辅助化疗后27例患者中24例获得手术切除,其中14例获得根治性切除。临床有效率为48．1%,其中3．7% (1例)完全缓解,44．4%(12例)部分缓解,33．3%(9例)病情稳定,18．5%(5例)病情进展。8例肿瘤TNM分期降低。不良反应主要为恶心呕吐、外周感觉神经异常、白细胞减少症、脱发、肝功能异常,对症治疗可缓解。无化疗相关死亡者。结论OXA-LV5FU2新辅助化疗方案在进展期胃癌的治疗中近期疗效显著,耐受性良好。
Objective To evaluate the efficacy and side effects of oxaliplatin (OXA) plus leucovorin (LV) and neoadjuvant chemotherapy with 5-fluorouracil (OXA-LV5FU2) in the treatment of advanced gastric cancer. Methods 27 patients with advanced gastric cancer received OXA-LVSFU2 treatment: OXA 100 mg / m 2, intravenous infusion of 2 h on the first day; LV 200 mg / m 2 intravenous infusion of 5-FU 400 mg / m ~ 2, followed by 5-FU 1g / m ~ 2 anesthesia analgesia pump for 48-72 h constant speed intravenous infusion, the first and second days. Every 2-3 weeks for a course of treatment, a total of 3 to 4 courses. To observe the neoadjuvant chemotherapy after the primary tumor remission and adverse reactions. Results Of the 27 patients who underwent neoadjuvant chemotherapy, 24 were surgically resected and 14 received radical resection. The clinical effective rate was 48.1%, of which 3.7% (1 case) was completely relieved, 44.4% (12 cases) partially relieved, 33.3% (9 cases) stable and 18.5% (5 cases Disease progression. 8 cases of TNM staging decreased. Adverse reactions mainly nausea and vomiting, peripheral sensory nerve abnormalities, leucopenia, hair loss, abnormal liver function, symptomatic treatment can be alleviated. No chemotherapy-related deaths. Conclusions OXA-LV5FU2 neoadjuvant chemotherapy regimen has significant short-term curative effect in the treatment of advanced gastric cancer and is well tolerated.