多西他赛联合奥沙利铂及氟尿嘧啶治疗晚期胃癌临床观察

目的评价多西他赛联合奥沙利铂及氟尿嘧啶方案治疗晚期胃癌的临床疗效与安全性。方法对无法手术切除的38例晚期胃癌患者采用多西他赛（75mg／m2，静脉滴注，第1天）联合奥沙利铂（75mg／m2，静脉滴注，第1天）及氟尿嘧啶（750mg／m2，静脉滴注，第1～5天）联合化疗。21d为1个周期，共2-6个周期。伴肝转移者先行选择性肝动脉化疗栓塞术。以反应率、疾病无进展时间、生存期、毒副反应作为评价标准。结果完全有效2例（5．3％），部分有效19例（50．0％），疾病稳定12例（31．6％），疾病进展5例（13.2％），总有效率55．3％（21／38），中位疾病无进展时间和中位总生存期分别为5．3个月和10．8个月。15例化疗后行手术治疗，伴随症状有不同程度缓解，Karnofsky评分明显提高。毒副反应为WHO3～4度者11例，其中嗜中性粒细胞减少6例（15．8％），白细胞减少3例（7．9％），恶心呕吐1例（2．6％），口腔黏膜炎1例（2．6％），无化疗相关死亡。结论多西他赛联合奥沙利铂及氟尿嘧啶方案治疗晚期胃癌疗效明显，不良反应轻且易于控制。

Docetaxel combined with oxaliplatin and 5-fluorouracil in treatment of advanced gastric cancer

Objective To evaluate the efficacy and safety of docetaxel combined with oxaliplatin and 5-fluorouracil in treatment of advanced gastric cancer. Methods Total 38 patients with unresectable advanced gastric carcinoma were enrolled in the study. The therapeutic regime consisted of docetaxel 75mg/m2 i.v gtt and oxaliplatin 75 mg/m2 i.v gtt at dl followed by 5-fluo- rouracil 750 mg/m2 i.v gtt dl-5; the regimen were repeated every 21 days, and all the patients received 2-6 cycles. Patients with hepatic metastasis underwent transcatheter hepatic arterial chemoembolization （TACE） before the chemotherapy. The response rate, time to progression, overall survival and toxicity were observed. Results Among 38 patients 2 achieved complete remission （5.3 %）, 19 partial remission （50.0 %）, 12 stable disease （31.6 %） and 5 progressive disease （13.2 %）. The overall response rate was 55.3 % （21/38）, the median time to progression and median overall survival for all patients was 5.3 months and 10.8 months, respectively. Fifteen patients were operated, their concomitant symptoms were ameliorated and Karnofsky performance scores were also improved. Eleven out of 38 patients had WHO Grade 3/4 toxicity, including neutropenia in 6（15.8 %）, leukopenia in 3 （7.9 %）, nausea/vomiting in 1 （2.6 %） and mouse mucositis in 1 （2.6 %）. There were no chemotherapy-related deaths during the treatment. Conclusion Docetaxel combined with oxaliplatin and 5-fluorouracil is a therapeutic regimen with high response and mild toxicity for patients with advanced gastric cancer.