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目的探讨中晚期胃癌应用FAM方案及LEF方案行选择性动脉插管治疗的疗效与毒副作用。方法2003年6月~2006年2月用FAM方案(5-氟脲嘧啶,表阿霉素,丝裂霉素)与LEF方案(5-氟脲嘧啶/亚叶酸钙,草酸铂)选择性动脉插管化疗治疗中晚期胃癌112例。结果FAM方案治疗56例,有效(CR+PR)46.4%,LEF方案治疗56例,有效(CR+PR)57.1%;两组疗效经χ2统计学处理差异无统计学意义,但LEF组疗效稍优于FAM组。两组毒副反应均有消化道反应和骨髓抑制,FAM方案的消化道反应较LEF组重,而骨髓抑制较LEF组轻;FAM组有3例出现心脏毒性反应。LEF组无明显的心脏毒性反应,但有明显神经毒性,多为Ⅰ-Ⅱ度,且为可逆性的。结论LEF组疗效稍优于FAM组,但差异无统计学意义;毒副作用经对症处理可耐受,无心脏毒性,神经毒性可逆。
Objective To investigate the curative effect and side effects of selective intra-arterial intubation with FAM regimen and LEF regimen in advanced gastric cancer. Methods From June 2003 to February 2006, selective arterial occlusion was induced by FAM regimen (5-fluorouracil, epirubicin and mitomycin) and LEF regimen (5-fluorouracil / leucovorin and oxaliplatin) Intubation chemotherapy for advanced gastric cancer in 112 cases. Results Fifty-six patients were treated with FAM regimen, effective (CR + PR) 46.4%, LEF regimen 56 cases, effective (CR + PR) 57.1%. There was no significant difference between the two groups Better than FAM group. The two groups of side effects were gastrointestinal reactions and bone marrow suppression, FAM regimen gastrointestinal reactions than LEF group, and myelosuppression lighter than LEF group; FAM group, 3 cases of cardiac toxicity. LEF group had no obvious cardiotoxicity, but obvious neurotoxicity, mostly Ⅰ-Ⅱ degree, and was reversible. Conclusion The efficacy of LEF group is slightly better than that of FAM group, but the difference is not statistically significant. Toxic side effects can be tolerated symptomatically without cardiotoxicity and neurotoxicity is reversible.