Chi K H, Chao Y, Chan W K, Lo S S, Chen S Y, Yen S H, Chen K Y, Wu C W, Lee S D, Lui W Y
Cancer Center, Veterans General Hospital-Taipei, National Yang-Ming University, Taiwan.
Br J Cancer. 1998 Jun;77(11):1984-8. doi: 10.1038/bjc.1998.329.
In order to optimize the therapeutic index of combining etoposide, epirubicin, cisplatin, 5-fluorouracil (5-FU), leucovorin (EEPFL) chemotherapy in the treatment of advanced gastric cancer, a trial of a novel schedule of weekly administration was conducted. Weekly EEPFL treatment consisted of a concomitant boost of etoposide 40 mg m(-2) i.v. over 30 min, epirubicin 10 mg m(-2) i.v. over 5 min to a backbone regimen, weekly PFL chemotherapy with cisplatin 25 mg m(-2), 5-FU 2200 mg m(-2), leucovorin 120 mg m(-2) given simultaneously by 24-h i.v. infusion. Response, survival and toxicity were evaluated. Forty-two patients were studied. Median age was 69 (range 31-84) years. Twenty-six per cent of patients showed complete response and 45% partial response. The overall response rate was 71% (95% confidence interval 58-84%). For a total of 507 weekly EEPFL cycles delivered, the incidence of grade 4 leucopenia was 1% of cycles. One patient died of neutropenia septicaemia. There was no other grade 4 toxicity. Grade 3 and 2 leucopenia occurred in 7% and 14% of cycles. The incidence of grade 3 and 2 mucositis was 1% and 3% of cycles. Grade 3 and 2 diarrhoea occurred in 0.4% and 1.6% of cycles. Overall median survival was 10 months (range 3-41+ months). Weekly EEPFL chemotherapy is an effective regimen with tolerable toxicities in the treatment of advanced gastric cancer. A randomized controlled clinical trial to formally assess the efficacy and benefit of EEPFL chemotherapy is under way.
为优化依托泊苷、表柔比星、顺铂、5-氟尿嘧啶（5-FU）、亚叶酸钙（EEPFL）联合化疗治疗晚期胃癌的治疗指数，开展了一项新型每周给药方案的试验。每周EEPFL治疗包括在30分钟内静脉注射40mg/m²依托泊苷、在5分钟内静脉注射10mg/m²表柔比星，同时加入顺铂25mg/m²、5-FU 2200mg/m²、亚叶酸钙120mg/m²的每周PFL化疗基础方案，通过24小时静脉输注同时给药。评估了反应、生存率和毒性。研究了42例患者。中位年龄为69岁（范围31-84岁）。26%的患者显示完全缓解，45%部分缓解。总缓解率为71%（95%置信区间58-84%）。在总共进行的507个每周EEPFL周期中，4级白细胞减少的发生率为周期数的1%。1例患者死于中性粒细胞减少败血症。无其他4级毒性。3级和2级白细胞减少分别发生在7%和14%的周期中。3级和2级粘膜炎的发生率分别为周期数的1%和3%。3级和2级腹泻分别发生在0.4%和1.6%的周期中。总体中位生存期为10个月（范围3-41+个月）。每周EEPFL化疗是治疗晚期胃癌的一种有效方案，毒性可耐受。一项正式评估EEPFL化疗疗效和益处的随机对照临床试验正在进行中。
