甲地孕酮联合DCF方案化疗对进展期胃癌患者生活质量的影响

目的 探讨甲地孕酮联合5-氟尿嘧啶+顺铂+多西紫杉醇(DCF)方案化疗对改善进展期胃癌(AGC)患者生活质量的作用.方法 42例AGC患者完全随机分为单纯DCF方案化疗组(DCF组,16例)和甲地孕酮联合DCF方案化疗组(甲地孕酮联合DCF组,26例),患者均给予DCF方案化疗,其中甲地孕酮联合DCF组同时给予甲地孕酮口服治疗,化疗方案为28 d为1个周期,至少化疗2个周期.观察并记录患者治疗前后卡氏行为状态(KPS)评分、食欲、体重情况以及化疗毒副作用、全身情况变化.结果 诊疗后甲地孕酮联合DCF组有20例(76.9％)KPS评分提高,DCF组有4例(25.0％) KPS评分提高,2组差异有统计学学意(P＜0.05)；甲地孕酮联合DCF组食欲增加者21例(80.8％),DCF组食欲增加者3例(18.8％),组间差异有统计学意义(P＜0.05).甲地孕酮联合DCF组体重增加者19例(73.1％),DCF组体重增加者2例(12.5％),组间差异有统计学意义(P＜0.05).甲地孕酮联合DCF组出现Ⅱ度以上胃肠道反应5例(19.2％),DCF组出现Ⅱ度以上胃肠道反应11例(68.8％),组间差异有统计学意义(P＜0.05).甲地孕酮联合DCF组出现Ⅱ度以上白细胞计数减少6例(23.1％),DCF组出现Ⅱ度以上白细胞计数减少10例(62.5％),组间差异有统计学意义(P＜0.05).结论 甲地孕酮联合DCF方案治疗AGC,可减轻化疗所致消化道反应及骨髓毒性,改善患者的生活质量.

Effect of medroxyprogesterone acetate combined with DCF regimen chemotherapy on life quality of patients with advanced gastric cancer

Objective To observe the effect of medroxyprogesterone acetate （MPA） combined with DCF （docetaxel, cisplatin, fluorouracil）regimen chemotherapy on improving life quality of patients with advanced gastric cancer （AGC）. Methods All 42 cases with AGC were randomly divided into DCF group treated only by chemo- therapy, and MPA combined with DCF group treated only by MPA combined with chemotherapy. The change of Karnofsky performance status （ KPS）, appetite, body weight toxicum reaction and the whole body change of two groups were observed. Results Of 42 cases, 20 cases （76.9%） improved on KPS in MPA combined with DCF group and 4 cases （25.0%） improved in DCF group, the difference between the two groups were statistically signifi- cant （P〈0.05） ; 21 cases （80.8%） had an increase on appetite and 19 cases （73.1%） had an increase on weight in MPA combined with DCF group, while the numbers in DCF group were 3 cases （18.8%） and 2 cases （12.5%） respectively, the difference between the two groups were statistically significant （P 〈 0.05）; 5 cases （ 19.2% ） had grade II or more gastrointestinal reaction in MPA combined with DCF group and 11 cases （68.8%） in DCF group, 6 cases （23.1%） had grade II or more leucopenia in MPA combined with DCF group and 10 cases （62.5） in DCF group, the difference between the two groups were statistically significant （P 〈0.05）. Conclusion MPA combined with DCF regimen chemotherapy can reduce gastrointestinal side effects and hematologic toxicities, in- crease appetite and improve life quality in patients with AGC.