Papadakou M, Xydakis E, Bonios M, Makropoulou E, Boukis C, Kakavoulis T, Karaliotas C, Panagos G
Department of Medical Oncology, Agii Anargiri Cancer Hospital, Kifisia, Athens, Greece.
J BUON. 2006 Jul-Sep;11(3):285-9.
The aim of this study was to evaluate the efficacy of cisplatin, etoposide, 5-fluorouracil (5-FU), and leucovorin (L; CEFL) combination chemotherapy given as adjuvant treatment to patients with stage III gastric cancer.
A total of 33 patients who had undergone curative resection for stage III gastric adenocarcinoma were enrolled in our adjuvant chemotherapy protocol to receive 6 cycles of CEFL starting within 8 weeks from surgery. CEFL consisted of cisplatin 30 mg/m2 on days 1-3; 5-FU 300 mg/m2 continuous infusion on days 1-3; and etoposide 90 mg/m2 on days 1-3. Cycles were repeated every 4 weeks. Relapse-free survival (RFS) and overall survival (OS) were estimated using Kaplan-Meier method. Comparison between groups was carried out using log-rank test.
Treatment was completed by 30 (91%) patients. After a mean follow-up of 31 months 15 (50%) patients have relapsed. Mean RFS was 31 months (range 6 to 114+). Patients with stage IIIA disease had longer RFS that those with stage IIIB (37 vs. 25 months, p>0.05). Mean OS was 35 months (range 4 to 114+), while stage IIIA patients survived longer than IIIB ones (42 vs. 27 months, p>0.05). Principal side effects of therapy were from the bone marrow and the gastrointestinal tract. There were 2 treatment-related deaths due to neutropenic sepsis.
CEFL regimen appears to be an effective adjuvant treatment for patients with stage III gastric carcinoma as it prolongs both RFS and OS. However, its pronounced myelotoxicity requires the prophylactic use of granulocyte colony stimulating factor (G-CSF).
本研究旨在评估顺铂、依托泊苷、5-氟尿嘧啶（5-FU）和亚叶酸钙（L；CEFL）联合化疗作为Ⅲ期胃癌患者辅助治疗的疗效。
共有33例接受了Ⅲ期胃腺癌根治性切除的患者纳入我们的辅助化疗方案，在术后8周内开始接受6个周期的CEFL治疗。CEFL方案包括第1 - 3天给予顺铂30mg/m²；第1 - 3天给予5-FU 300mg/m²持续输注；第1 - 3天给予依托泊苷90mg/m²。每4周重复一个周期。采用Kaplan-Meier法估计无复发生存期（RFS）和总生存期（OS）。组间比较采用对数秩检验。
30例（91%）患者完成了治疗。平均随访31个月后，15例（50%）患者复发。平均RFS为31个月（范围6至114 +）。ⅢA期疾病患者的RFS长于ⅢB期患者（37个月对25个月，p>0.05）。平均OS为35个月（范围4至114 +），ⅢA期患者的生存期长于ⅢB期患者（42个月对27个月，p>0.05）。治疗的主要副作用来自骨髓和胃肠道。有2例因中性粒细胞减少性败血症导致的治疗相关死亡。
CEFL方案似乎是Ⅲ期胃癌患者有效的辅助治疗方案，因为它延长了RFS和OS。然而，其明显的骨髓毒性需要预防性使用粒细胞集落刺激因子（G-CSF）。
