常见肿瘤化疗方案(2004.10.30)一、头颈部癌1、DDP+5-FuCisplatin100mg/m25-Fluorouracil1000mg/m23~4周重复,也可用于放疗前2、CBP+5-FuCarboplatin300mg/m25-Fluorouracil1000mg/m23~4周重复3、IPIfosfamide(异环磷酰胺)1500mg/m2 Cisplatin10mg/m24周重复4、TIPPaclitaxel(紫杉醇)175mg/m2Ifosfamide1000mg/m2Cisplatin60mg/m23~4周重复5、TICPaclitaxel175mg/m2Ifosfamide1000mg/m2CarboplatinAUC=63~4周重复6、Docetaxel+CisplatinDocetaxel(多西紫杉醇)100mg/m2 Cisplatin75mg/m23周重复7、Docetaxel+Cisplatin+5-Fluororacil(TPF)Docetaxel75mg/m2Cisplatin100mg/m25-Fluorouracil1000mg/m23周重复i.v.(1h inf)i.v.(cont inf)i.v.i.v.(cont inf)i.v.(Mesna保护)i.v.(30min inf)i.v.(3h inf)i.v.(2h,Mesna保护)i.v.i.v.(3h inf)i.v.(2h,Mesna保护)i.v.(30min inf)i.v.(1h inf)i.v.(3h inf)i.v.i.v.i.v.(cont inf)d1d1-4(5)d1d1-4d1-5d1-5d1d1-3d1d1d1-3d1d1d1d1d1d1-4CisplatinBleomycin(博来霉素)5-Fluorouracil4周重复9、BECCisplatinEpirubicin(表柔比星)Bleomycin4周重复二、乳腺癌1、经典CMF Cyclophosphamide(环磷酰胺)Methotrexate(氨甲喋呤)5-Fluorouracil4周重复2、改良CMF CyclophosphamideMethotrexate5-Fluorouracil3周重复3、ACDoxorubicin(阿霉素(化疗药物))Cyclophosphamide3周重复4、ECEpirubicin Cyclophosphamide3周重复5、IEIfosfamideEpirubicin100mg/m215mg16mg/m2650mg/m2100mg/m270mg/m215mg12mg/m2100mg/m240mg/m2600mg/m2600mg/m240mg/m2600mg/m260mg/m2600mg/m260mg/m2600mg/m22000mg/m230mg/m2i.v.(1h inf)i.v.(bolus)i.v.(cont inf)i.v.(cont inf)i.v.(1h inf)i.v.(bolus)i.v.(bolus)i.v.(cont inf)p.o.i.v.i.v.i.v.i.v.i.v.i.v.i.v.i.v.i.v.(Mesna保护)i.v.d1d1 followed byd1-5 d1-5d1d1d1 followed byd1-5 d1-14d1,8d1,8d1d1d1d1(,8)d1d1d1,8d1,83周重复6、AC+TDoxorubicin60mg/m2 Cyclophosphamide600mg/m2 3周重复,共4周期,然后Paclitaxel175mg/m23周重复,共4周期7、CAF Cyclophosphamide500mg/m2 Doxorubicin50mg/m25-Fluorouracil500mg/m23周重复8、CEF Cyclophosphamide500mg/m2 Epirubicin100mg/m25-Fluorouracil500mg/m23周重复9、Paclitaxel单药Paclitaxel175或200mg/m23周重复10、TADoxorubicin50mg/m2 Paclitaxel220mg/m23周重复11、Docetaxel单药Docetaxel75或100mg/m23周重复或者Docetaxel40mg/m23周重复12、Docetaxel+Doxorubicin Doxorubicin50mg/m2 Docetaxel75mg/m23周重复13、Vinorelbine+Doxorubicini.v.i.v.i.v.(3h inf)i.v.i.v.i.v.i.v.i.v.i.v.i.v.(3h inf)i.v.i.v.(3h inf)i.v.(1h inf)i.v.(1h inf)i.v.i.v.(1h inf)d1 d1d1d1d1d1d1d1d1d1d1d2(ADM后24h)d1d1d1Doxorubicin40-50mg/m2 Vinorelbine20-25mg/m23周重复14、Capecitabine单药Capecitabine2510mg/m23周重复15、Trastuzumab单药Trastuzumab4mg/kg2mg/kg三、肺癌(一)小细胞肺癌的化疗(SCLC)1、CAOCyclophosphamide1000mg/m2 Doxorubicin(阿奇霉素)50mg/m2Vincristine2mg3周重复2、CEV Cyclophosphamide1000mg/m2 Epirubicin70mg/m2 Vincristine2mg3周重复3、EPCisplatin80mg/m2 Etoposide100mg/m23周重复4、ECCarboplatin300mg/m2 Etoposide120mg/m24周重复5、CAE Cyclophosphamide1000mg/m2 Doxorubicin40-50mg/m2 Etoposide100-120mg/m2i.v. i.v.p.o.i.v.(90 min inf)i.v.(30 min inf)i.v.i.v.i.v.i.v.i.v.i.v.i.v.(1h inf)i.v.(2h inf)i.v.i.v.(2h inf)i.v.i.v.i.v.(1h inf)d1d1,8分两次/天,d1-14负荷量维持量,qwd1d1d1d1d1d1d1d1-3d1d1-3d1d1d1-36、VIPEtoposide75mg/m2 Ifosfamide1200mg/m2 Cisplatin20mg/m23周重复7、Topotecan单药Topotecan1.5mg/m23周重复8、Paclitaxel+Carboplatin Paclitaxel175mg/m2 CarboplatinAUC=73周重复(二)非小细胞肺癌的化疗(NSCLC)1、Docetaxel单药Docetaxel75mg/m23周重复2、Gemcitabine单药Gemcitabine1000-1250mg/m24周重复3、Vinorelbine单药Vinorelbine30mg/m24周重复4、NPVinorelbine25mg/m2Cisplatin100mg/m24周重复5、Paclitaxel+CisplatinPaclitaxel175mg/m2Cisplatin80mg/m23周重复6、Paclitaxel+CarboplatinPaclitaxel225mg/m2 CarboplatinAUC=63周重复7、Docetaxel+Cisplatini.v.i.v.(Mesna保护)i.v.i.v.(30min inf)i.v.(3h inf)i.v.(30min inf)i.v.(1h inf)i.v.(30min inf)i.v.(20min inf)i.v.i.v.i.v.(3h inf)i.v.(1h inf)i.v.(3h inf)i.v.d1-4d1-4d1-4d1-5d1d1d1d1,8,15d1,8,15d1,8,15d1d1d1d1d1DocetaxelCisplatin3周重复75mg/m75mg/m2i.v.i.v.d1d128、Gemcitabine+CisplatinGemcitabineCisplatin1000mg/m100mg/m2i.v.(30-60min inf)d1,8,15i.v.(30-60min inf)d1 24周重复9、EPCisplatin100mg/m2Etoposide100mg/m23周重复四、食管癌1、DDP+5-FuCisplatin100mg/m25-Fluorouracil1000mg/m23~4周重复2、Paclitaxel+Cisptatin Paclitaxel180mg/m2 Cisplatin60mg/m23周重复3、TPEPaclitaxel50mg/m2Cisplatin15mg/m2Etoposide50mg/m2QW*3,休息1周,4周一疗程4、ECFEpirubicin50mg/m2Cisplatin60mg/m25-Fluorouracil200mg/m23周重复五、胃癌1、5-Fu+CF+DDPCisplatin50mg/m2i.v.(30-60min inf)i.v.(2h inf)i.v.(2h inf)i.v.(cont inf)i.v.(3h inf)i.v.(3h inf)i.v.(1h inf)i.v.(1h inf)i.v.(cont inf)i.v.i.v.i.v.(cont inf)i.v.(1h inf)d1d1-3d1d1-5d1d1d1,4d1,4d1,4d1d1d1-21biwFolinic acid500mg/m25-Fluorouracil2000mg/m2 2、ECFEpirubicin50mg/m2 Cisplatin60mg/m25-Fluorouracil200mg/m2 3周重复3、FAMTX Methotrexate1~1.5g/m2 5-Fluorouracil1500mg/m2 Doxorubicin30mg/m2 Folinic acid15mg/m24周重复4、ELFEtoposide120mg/m2Folinic acid300mg/m25-Fluorouracil500mg/m23~4周重复5、TCDocetaxel85mg/m2Cisplatin75mg/m23周重复六、大肠癌1、Mayo ClinicFolinic acid20mg/m25-Fluorouracil425mg/m24周重复2、de GramontFolinic acid200mg/m25-Fluorouracil400mg/m2600mg/m22周重复3、Irinotecan Monotherapy Irinotecan125mg/m2i.v.(2h inf)i.v.(24h inf)i.v.i.v.(cont inf)i.v.i.v.i.v.p.o.i.v.(50min inf)i.v.(10min inf)i.v.(10min inf)i.v.(1h inf)i.v.(1h inf)i.v.(bolus)i.v.(bolus)i.v.(2h inf)i.v.(bolus)i.v.(22h inf)i.v.(90min inf)qw*6 qw*6d1d1d1-21d1d15MTX后24h,q6h*12d1-3 d1-3d1-3d1d1d1-5d1-5d1-2d1-2d1-2qw*46周重复或者Irinotecan300-350mg/m2 3周重复4、FOLFORIIrinotecan125mg/m2 Folinic acid20mg/m25-Fluorouracil500mg/m26周重复或者Irinotecan180mg/m2 Folinic acid200mg/m25-Fluorouracil400mg/m2 600mg/m22周重复5、Irinotecan+Oxaliplatin Irinotecan200mg/m2 Oxaliplatin85mg/m23周重复6、Oxaliplatin Monotherapy Oxaliplatin130mg/m23周重复7、FOLFOX4Oxaliplatin85mg/m2 Folinic acid200mg/m25-Fluorouracil400mg/m2 600mg/m22周重复8、FOLFOX6Oxaliplatin100mg/m2Folinic acid400mg/m25-Fluorouracil400mg/m2 2400~3000mg/m22周重复9、Raltitrexedi.v.(90min inf)i.v.(90min inf)i.v.(bolus)i.v.(bolus)i.v.(90min inf)i.v.(2h inf)i.v.(bolus)i.v.(22h inf)i.v.(30min inf)i.v.(2h inf)i.v.(2h inf)i.v.(2h inf)i.v.(2h inf)i.v.(bolus)i.v.(22h inf)i.v.(2h inf)i.v.(2h inf)i.v.(bolus)i.v.(46h inf)d1 qw*4qw*4qw*4d1d1-2d1-2d1-2d1d1d1d1d1-2d1-2d1-2d1d1d1-2d1-2Raltitrexed3mg/m23周重复10、CapecitabineCapecitabine1250mg/m23周重复11、UFT+CFUFT100mg/m2Folinic acid30mg/m25周重复七、胰腺癌1、GemcitabineGemcitabine1000mg/m2i.v.(30min inf)2、5-Fluorouracil5-Fluorouracil500mg/m24周重复3、CF+5-FuFolinic acid20mg/m25-Fluorouracil425mg/m24周重复4、Gemcitabine+CF+5-FuGemcitabine1000mg/m2Folinic acid200mg/m25-Fluorouracil750mg/m26周重复八、胆管癌1、5-Fluorouracil5-Fluorouracil500mg/m24周重复或者5-Fluorouracil600mg/m24周重复2、Gemcitabinei.v.d1p.o.bid*14p.o.tid*28p.o.tid*28qw*7;休息1周后每周1次,连用3周,4周一疗程i.v.(bolus)d1-5i.v.(2h inf)d1-5i.v.(bolus)d1-5i.v.(30min inf)d1,8,15,22i.v.(2h inf)d1,8,15,22i.v.(cont inf)d1,8,15,22i.v.d1-5i.v.d1,8,154周重复3、GemcitabineGemcitabine4、Docetaxel Docetaxel3周重复5、FLM Folinic acid5-Fluorouracil Mitomycin4周重复6、5-Fu+IFN-a 5-Fluorouracil Interferon alpha 2周重复九、宫颈癌1、IP Ifosfamide Cisplatin3周重复2、IC Ifosfamide Carboplatin3、BIPBleomycin Ifosfamide Cisplatin4周重复4、TIPPaclitaxel2200mg/m2 100mg/m2200mg/m2400mg/m28mg/m2750mg/m25*106IU5000mg/m250mg/m25000mg/m2300mg/m230mg/m25000mg/m250mg/m2175mg/m2i.v.(30min inf)d1 i.v.(1h inf)d1i.v.d1-4i.v.d1-4i.v.d1i.v.(cont inf)d1-5s.c.d1,3,5i.v.(24h inf,Mesna保护)d1i.v.d1i.v.(24h inf,Mesna保护)d1i.v.d1i.v.(24h inf)d1i.v.(24h inf,Mesna保护)d2i.v.d2i.v.(3h inf)d1i.v.(24h inf,Mesna保Cisplatin50mg/m24周重复5、TPPaclitaxel135mg/m2Cisplatin50~75mg/m23周重复6、PFCisplatin75mg/m25-Fluorouracil1000mg/m23周重复,也可同时合并放疗十、子宫内膜癌1、APDoxorubicin60mg/m2 Cisplatin50~60mg/m23周重复2、TCPaclitaxel175mg/m2 CarboplatinAUC=5~73周重复3、PCDDoxorubicin45mg/m2 Paclitaxel160mg/m2 Cisplatin60mg/m23周重复,G-CSF支持十一、卵巢癌一线化疗1、TPPaclitaxel135mg/m2 Cisplatin75mg/m23周重复2、TCPaclitaxel175mg/m2 CarboplatinAUC=5~6i.v.i.v.(24h inf)i.v.i.v.i.v.(cont inf)i.v.i.v.i.v.(3h inf)i.v.(30min inf)i.v.i.v.(3h inf)i.v.(1h inf)i.v.(3h或24h inf)i.v.(1mg/min)i.v.(3h inf)i.v.(1h inf)d2d1d2d1d1-4d1d1d1d1d1d1d1d1d1或d2d1d13周重复3、CBP+CTX Cyclophosphamide Carboplatin4周重复挽救治疗1、TopotecanTopotecan3周重复2、Etoposide Etoposide3周重复3、Gemcitabine Gemcitabine4周重复4、Ifosfamide Ifosfamide3~4周重复或者Ifosfamide4周重复5、IP Ifosfamide Paclitaxel3周重复6、IM Ifosfamide Mitoxantrone3~4周重复7、脂质体ADM脂质体ADM4周重复十二、绒毛膜癌600mg/m2300mg/m21.0~1.5mg/m250~100mg/m2800~1250mg/m21200~2400mg/m21000mg/m21500mg/m2175mg/m22000mg/m210mg/m250mg/m2i.v.d1i.v.(1h inf)d1i.v.(30min inf)d1-5p.o.d1-14i.v.(30min inf)d1,8,15i.v.(30min~2hinf,Mesna 保护)d1-5i.v.(con inf,Mesna保护)d1-7i.v.(1hinf,Mesna保护)d2-5i.v.(3h inf)d1 i.v.(30mininf,Mesna保护)d1-3i.v.(30min inf)d1i.v.(1h inf)d1低危1、MethorexateMethorexate0.4~0.6mg/kgi.m.或i.v.(bolus)d1-5周重复2、DactinomycinDactinomycin周重复高危1、EMA-COEtoposideMethorexateDactinomycinCyclophosphamideVincristine3周重复2、MACMethorexateDactinomycin Cyclophosphamide Chlorambucil2~3周重复3周重复3、挽救治疗低危1、EA Etoposide Dactinomycin10天重复高危1、EP/EMAEPEtoposide CisplatinEMA10~12ug/kg 100mg/m2100mg/m2200mg/m20.5mg/m2600mg/m21.0mg/m20.3mg/kg8~10ug/kg250mg0.2mg/kg100mg/m20.5mg/m2150mg/m275mg/m2i.v.(bolus)i.v.(1h inf)i.v.i.v.(12h inf)i.v.(bolus)i.v.(30min inf)i.v.(bolus)i.m.i.v.(bolus)i.v.(bolus)p.o.i.v.(1h inf)i.v.(bolus)i.v.(30min inf)i.v.(4h inf)d1-5 d1-2d1d1d1-2d8d8d1-5d1-5d1-5d1-5d1-3d1-3d1d1Etoposide Methorexate Dactinomycin Folinic acidEP/EMA每周交替100mg/m300mg/m0.5mg15mg2i.v.(30min inf)i.v.(12h inf)i.v.(bolus)d1d1d12bid,p.o.或i.m.(MTX后24h,q6h*4)d2,3 十三、生殖细胞恶性肿瘤(一)非精原细胞瘤1、BEPBleomycinEtoposideCisplatin3周重复2、ACEDactinomycinCyclophosphamideEtoposide3、VIPEtoposide IfosfamideCisplatin3周重复,G-CSF支持4、T-BEP Paclitaxel Bleomycin EtoposideCisplatin3周重复,G-CSF支持5、VeIP Vinblastine Ifosfamide30mg/m2 100mg/m2或165mg/m250mg/m2或20mg/m20.5mg500mg/m2200mg/m21600mg/m230mg/m2175mg/m230mg200mg/m230mg/m20.11mg/kg1200mg/m2i.v.(bolus)d1,8,15i.v.(1h inf)d1-5 i.v.(1h inf)d1-3i.v.d1-2i.v.d1-5i.v.(bolus)d1-3i.v.(30min inf)d3i.v.(1h inf)d1-3i.v.(1h inf)d1-5i.v.(1hinf,Mesna保护)d1-5i.v.(1h inf)d1-5 i.v.(1h inf)d1i.v.(bolus)d1,8,15i.v.(1h inf)d1-5i.v.(1h inf)d1-5i.v.(bolus)d1-2i.v.(1h inf,Mesna保护)d1~53周重复6、TIPPaclitaxelIfosfamide250mg/m2i.v.(24h inf)d11200mg/m2i.v.(1hinf,Mesna保护)d2-6Cisplatin 3周重复,G-CSF支持(二)精原细胞瘤EP1、BEPEtoposideCisplatin3周重复2、VeIPVinblastineIfosfamideCisplatin3周重复十四、原发不明转移瘤Paclitaxel Carboplatin Etoposide3周重复2、PEB Bleomycin Etoposide Cisplatin3周重复3、DC Docetaxel Carboplatin3周重复20mg/m2 100mg/m220mg/m20.11mg/kg1200mg/m220mg/m2200mg/m2AUC=6100mg30mg100mg/m220mg/m265mg/m2AUC=6i.v.(30min inf)i.v.(1h inf)i.v.(30min inf)i.v.(bolus)i.v.(1h inf,Mesna保护)i.v.(30min inf)i.v.(1h inf)i.v.(20~30min inf)p.o.p.o.i.v.(bolus)i.v.(1h inf)i.v.i.v.d1-5d1-5d1-2d1~5d1~5d1d1d1,3,5,7,9d2,4,6,8,10d1,8,15d1-5 d1~5d1d1PaclitaxelFolinic acid5-Fluorouracil4周重复5、VACVinblastineDoxorubicin Cyclophosphamide3周重复十五、恶性黑色素瘤1、DacarbazineDacarbazine175mg/m300mg2i.v.(3h inf)d1i.v.(30~60min inf)d1-32350mg/mi.v.(30~60min inf)d1-3 1.4mg/m50mg/m2i.v.i.v.i.v.d1d1d12500mg/m2850~1000mg/m或者250mg/m22i.v.i.v.d1d1-53~4周重复2、FotemustineFotemustine3周重复3、VindesineVinblastine3mg/m2100mg/m2i.v.(1h inf)d1,8,15i.v.d12周重复,共1年;然后3周重复,共6月;最后4周重复,共6月4、低剂量IFNInterferon alpha5、中剂量IFNInterferon alpha6、高剂量IFNInterferon alpha7、Interleukin-2Interleukin-28、Dartmouth方案CisplatinBCNU25mg/m23MUs.c.tiw6-36月10MU5MUs.c.5天/周s.c.tiw4周;然后2年20MU/m10MU/m2i.v.或5天/周s.c.tiw4周;然后48周2600000或720000IU/kgi.v.(15min)每8小时一次,共14次,2周重复;若耐受,6~12周为一疗程,最多5疗程i.v.(30~45min inf)d1-3i.v.(short inf)d1150mg/m2Dacarbazine220mg/m2i.v.(short inf)Tamoxifen20~40mgp.o.3周重复9、DVPDacarbazine250mg/m2i.v.(30min inf)Vindesine3mg/m2i.v.(bolus)Cisplatin100mg/m2i.v.(30min inf)4周重复10、Dacarbazine+Interferon alphaDacarbazine800mg/m2i.v.(short inf)Interferon alpha9MUs.c.tiw3周重复11、Dacarbazine+Cisplatin+Interferon alpha+Interleukin-2Dacarbazine250mg/m2i.v.(30min inf)。