三种化疗方案治疗晚期胃癌的疗效分析

目的：比较TPF（paclitaxel＋DDP＋5-FU）、HPLF（HCPT＋DDP＋CF＋5-FU）和FOLFOX4（oxaliplatin＋CF＋5-FU）三种化疗方案治疗晚期胃癌的临床疗效和不良反应。方法：回顾性分析65例晚期胃癌患者，根据化疗方案分为TPF方案组（21例）、HPLF方案（19例）和FOLFOX4方案组（25例），对三组疗效和不良反应进行比较。结果：TPF组、HPLF组、FOLFOX4组有效率分别为57．14％、52．63％和56％，三组疗效相比无统计学差异（P〉0．05）；中位进展时间（TTP）分别是6．6月、6．1月和6．2月（P〉0．05）；三组不良反应主要为胃肠道反应、外周神经毒性和脱发，除TPF组与FOLFOX4组外周神经毒性差异有显著性（P〈0．05）外，余均无统计学差异（P〉0．05）。结论：三种方案均是治疗晚期胃癌较为有效的化疗方案，但TPF方案治疗晚期胃癌耐受性较好，生活质量较高，值得临床推广。

Clinical analysis of three regimens in the treatment of advanced gastric cancer

Objective：To analyze the clinical efficacy and the side effects of the regimen TPF（ paclitaxel ＋ DDP ＋ 5 - FU） ,HPLF（ HCPT ＋ DDP ＋ CF plus 5 - FU） and FOLFOX4 （oxaliplatin ＋ CF ＋ 5 - FU） in the treatment of ad vanced gastric cancer. Methods：Sixty five patient s with advanced gastric carcinoma were retrospectively analyzed, which were divided into three groups according to what chemotherapy they received：TPF group（21 patients）, HPLF group（ 19 patients） and FOLFOX4 group（25 patients）. The efficacy and the adverse reaction of the three regiments were evaluated. Results： The effective rates was 57.14% in TPF group,52.63% in HPLF group and 56% in FOLFOX4 group （ P 〉 0. 05 ） ; TTPs were 6.6,6.1 and 5.2 months for TPF group, HPLF group and FOLFOX4 group （ P 〉 0.05 ） ;The main side effects were nausea, vomiting, peripheral neurotoxcity and alopecia, and the peripheral neurotoxcity of TPF group was much lower than FOLFOX4 group （P 〈 0.05 ）, while the other side effects were similar in all groups. Conclusion： All three regimens have good efficacy in treatment of the patients with advanced gartric carcinoma, and the effective rate and TTP was not significanly different among the three groups. While the TPF regiment was more effective and safe, also the patients receiving it had a better quality of life and increased survival rate.