Lu Ming, Shen Lin, Li Jie, Li Yan, Zhang Xiao-dong
Depatment of Gastrointestinal Oncology, Beijing University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100036, China.
Zhonghua Zhong Liu Za Zhi. 2009 May;31(5):392-5.
To investigate the efficiency, time to progression (TTP), overall survival (OS) and toxicity of epirubicin combined with DDP and 5-Fu (PELF regimen) for the treatment of advanced gastric cancer.
Totally, 101 patients with histopathologically confirmed advanced gastric cancer were enrolled and treated with PELF regimen in this study. Among them, 37 cases received adjuvant chemotherapy after R0 resection and 64 cases only received palliative chemotherapy without surgical resection. The regimen comprised of intravenous (i.v.) administration of epirubicin 50-80 mg/m2 for palliative chemotherapy or 40-50 mg/m2 for postoperative adjuvant chemotherapy on D1; i.v. infusion of cisplatin 10-20 mg/m2 in 2 hours on D1-D5; i.v. infusion of 5-Fu 425-600 mg/m2 for palliative chemotherapy or 425-500 mg/m2 for adjuvant chemotherapy in 4 hours for 5 days or continuous infusion for 120 hours; i.v. infusion of leucovorin (LV) 100-200 mg/m2 in 2 hours on D1-D5. This regimen was repeated every 3 to 4 weeks, and the first evaluation was done after two cycles.
Of the 37 patients who received adjuvant chemotherapy after R0 resection, 17 were still alive without recurrence, while 19 died of the disease. The median disease free survival time was 36.1 months and 5-year survival rate was 36.0%. Among the 64 cases who received only palliative chemotherapy, 47 patients were treated with this regimen as a first-line therapy and 34 patients were evaluable for response. The overall response rate was 26.5%, median time to progression (TTP) and overall survival (OS) was 6.6 and 13.7 months, respectively. Of the 17 patients who received this regimen as a second-line therapy, 10 were evaluable with an overall response rate of 20.0%. The median time to progression (TTP) in patients of this group was 5.1 months and median overall survival (OS) was 8.9 months. All the 101 patients were assessable for toxicity according to WHO criteria. The rate of grade 3 or 4 neutropenia, anemia and thromobocytopenia was 19.8%, 1.0% and 2.0%, respectively.
The regimen of epirubicin combined with DDP and 5-Fu is effective, well tolerable and safe for advanced gastric cancer patients either as adjuvant or as palliative therapy.
探讨表柔比星联合顺铂及5-氟尿嘧啶（PELF方案）治疗晚期胃癌的疗效、疾病进展时间（TTP）、总生存期（OS）及毒性。
本研究共纳入101例经组织病理学确诊的晚期胃癌患者，采用PELF方案进行治疗。其中，37例患者在R0切除术后接受辅助化疗，64例患者仅接受姑息化疗，未行手术切除。该方案包括：姑息化疗时静脉注射表柔比星50 - 80mg/m²，术后辅助化疗时为40 - 50mg/m²，于第1天给药；顺铂10 - 20mg/m²在第1 - 5天2小时内静脉滴注；5-氟尿嘧啶姑息化疗时425 - 600mg/m²，辅助化疗时425 - 500mg/m²，在4小时内静脉滴注5天或持续静脉滴注120小时；亚叶酸钙（LV）100 - 200mg/m²在第1 - 5天2小时内静脉滴注。该方案每3至4周重复一次，两个周期后进行首次评估。
37例R0切除术后接受辅助化疗患者中，17例仍存活且无复发，19例死于疾病。无病生存期的中位数为36.1个月，5年生存率为36.0%。在64例仅接受姑息化疗的患者中，47例患者将该方案作为一线治疗，34例患者可评估疗效。总缓解率为26.5%，疾病进展时间（TTP）中位数和总生存期（OS）分别为6.6个月和13.7个月。17例将该方案作为二线治疗的患者中，10例可评估疗效，总缓解率为20.0%。该组患者的疾病进展时间（TTP）中位数为5.1个月，总生存期（OS）中位数为8.9个月。根据WHO标准，所有101例患者均可评估毒性。3或4级中性粒细胞减少、贫血和血小板减少的发生率分别为19.8%、1.0%和2.0%。
表柔比星联合顺铂及5-氟尿嘧啶方案对晚期胃癌患者无论是作为辅助治疗还是姑息治疗均有效、耐受性良好且安全。
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