中文摘要：

目的 评价改良FOLFOX方案联合介入治疗进展期胃癌的疗效与安全性。方法 34例进展期胃癌患者接受改良FOLFOX方案联合介入治疗，每4 ～ 5周重复1次，直到出现疾病进展、不能接受的毒性、或者患者选择终止治疗结束，平均7个疗程。不良反应按照NCI毒性标准记录，数据经SPSS 15．0统计软件采用ＫａｐｌａｎMｅｉｅｒ生存分析。结果 所有患者都能耐受治疗，平均随访17个月，最长随访时间为32个月。CR 4例，PP 20例，NC 6例和PD 4例，ＲＲ 70．6％。中位生存期18个月，1年、2年、32个月累积生存率分别为76．5％，33．1％， 12．5％。NCI 1～ 2级不良反应包括：白细胞减少（31．9％），血小板减少（11．8％），贫血（11．8％），恶心，呕吐（41．2％），腹泻（29．4％），ALT升高（5．9％），脱发（64．7％），周围神经炎（11．8％），NCI 3 ～ 4级不良反应包括恶心、呕吐（47．1％），腹泻（11．8％）。4例出现3级ALT升高。无一例患者发生与治疗相关的患者死亡。结论 改良FOLFOX方案联合介入治疗进展期胃癌疗效较高，不良反应轻，因而相当安全。

英文摘要：

Objective To evaluate the efficacy and safety of modified Folfox regimen in combination with interventional therapy for patients with advanced gastric cancer. Methods Thirty-four patients were treated with modified Folfox regimen in combination with interventional therapy which was given at intervals of 4 or 5 weeks until the disease became worse, or the patient could not tolerate the drug toxicity, or the patient decided to stop the treatment. On an average, each patient received 7 therapeutic courses. Response to treatment and toxicity reaction to the drug were recorded according to NCI toxicity criteria. All data were analyzed by using Kaplan-Meier method with SPSS software （version 15.0, Chicago, IL, USA）. Results All patients tolerated the toxicity and treatment. The mean follow-up period was 17 months, with the longest period being of 32 months. Of 34 patients, complete remission was seen in 4 （11.8%）, partial remission in 20 （58.8%）, stable condition in 6 （17.6%） and deterioration in 4 （11.8%）. The overall response rate was 70.6%. The cumulated survival rate at 12, 24 and 32 months was 76.5%, 33.1% and 12.5% respectively, with a median survival time of 18 months. NCI grade 1 or 2 toxicities occurred, including alopecia （64.7%）, peripheral nenritis （11.8%）, anemia （11.8%）, leneopenia （31.9%）, diarrhea （29.4%）, stomatitis （23.5%）, thrombocytopenia （11.8%） and elevated ALT （5.9%）. Grade 3 or 4 occurred in 47.1% and 11.8% of patients respectively, which included nausea, vomiting and diarrhea. Four patients developed grade 3 ALT elevation. No treatment-related death occurred. Conclusion Modified Folfox regimen in combination with interventional therapy is a safe and effective treatment for advanced gastric cancer with fewer adverse effects. （J Intervent Radiol, 2009, 18： 759-762）