含紫杉类的三种化疗方案一线治疗晚期胃癌的疗效比较

目的观察含紫杉类的三种联合化疗方案-线治疗晚期胃癌的疗效及毒性反应,分析比较各组方案的安全性和有效性。方法选择2011年9月至2013年7月收治的86例初治晚期胃癌患者,包括30例患者中采用多西他赛＋5-氟脲嘧啶（DF）方案治疗,为DF组,29例采用多西他赛＋奥沙利铂＋5-氟脲嘧啶（DOF）治疗,为DOF组,27例多采用多西他赛＋顺铂＋5-氟脲嘧啶（DCF）方案治疗,为DCF组。化疗两周期后按照RECIST1．0标准评价近期疗效,按NCICTC3．0版评价毒性反应并随访生存情况。结果DF组、DOF组和DCF组的有效率（RR）分别为43．33％（13／30）、48．28％（14／29）、44．44％（12／27）;疾病控制率（DCR）分别为66．67％（20／30）、72．41％（21／29）、70．37％（19／27）;DF组、DOF组和DCF组中位无进展时间（TTP）、中位生存时间差异均无统计学意义（P〉0．05）。三组方案中主要毒副反应,主要表现为纳差、恶心呕吐等胃肠道反应,骨髓抑制,周围感觉神经毒性,黏膜炎。其中DCF组和DOF胃肠道反应、骨髓抑制、周围神经毒性方面分别为59．26％（16／27）、55．56％（15／27）、40．74％（11／27）和58．62％（17／29）、55．17％（17／29）、55．17％（16／29）、51．72％（15／29）,均显著高于DF组,差异有统计学意义（P〈0．05）。结论DF、DOF及DCF方案均是晚期胃癌治疗的一线方案,疗效相近。但使用DF方案患者化疗毒性反应较轻,化疗耐受性较好,值得临床推广使用。

The efficacy comparison of three kinds of chemotherapy containing taxane for the treatment of advanced gastric cancer.

Objective To observe three taxane - containing combination chemotherapy first - line treatment in advanced gastric cancer and toxicity, analyze and compare each groups safety and effectiveness of programs. Methods 86 patients with gastric cancer initially were trea- ted in our hospital from September in 2011 to August in 2013.. 30 patients treated with docetaxel and 5 - fluorouraeil （DF） （ DF group）, 29 ca- ses with doeetaxel plus oxaliplatin and 5 - fluorouracil （DOF） treatment（ DOF group）. 27 eases were treated with Doeetaxel ,eisplatin and 5 - fluorouraeil （DCF） （DCF group）. After two cycles chemotherapy, toxicity were evaluated and survival were follow -up according to standard e- valuation RECIST1.0 term efficacy and NCI CTC3.0 version. Results The efficiency of DF group, DOF group and DCF group （RR） were 43. 33% （13/30） , 48.28% （14/29） , 44.44% （12/27）. Disease eontrel rate （DCR） were 66.67% （20/30） , 72.41% （21/29） , 70.37% （ 19/27 ）. Progression free time （TTP） of DF group, DOF group and DCF group were 6.2 months, 7.1 months and 7 months, the median survival time were 10.8 months, 10.9 months and 10.4 months. The differences were not significant statistically （ P 〉0.05 ）. The main side effects of three groups were mainly anorexia, nausea and vomiting, bone marrow suppression, peripheral sensory nerve toxicity, mueositis. Gastrointestinal reactions, bone marrow suppression, peripheral neurotoxieity in The DCF group and the DOF were 59.26% （ 16/27）, 55.56% （ 15/27）, 40. 74% （ 11/27 ） and 58.62% （ 17/29 ）, 55.17 % （ 17/29 ）, 55.17 % （ 16/29 ）, 51.72% （ 15/29 ）, whieh were significantly higher than those of DF group. The difference was signifieant statistically （ P 〈 0.05 ）. Conclusion DF, DOF and DCF scheme were first - line treatment for late gastric cancer. There were similar effect. But the use of DF regimen chemotherapy were relatively mild toxicities, chemotherapy tolerated well and was worthy of clinical use.