TX方案治疗铂类治疗失败的进展期胃癌的临床疗效分析

目的：评价紫杉醇联合卡培他滨作为含铂类药物治疗失败的进展期胃癌二线治疗的疗效及安全性。方法：既往接受FP或者FOLFOX4方案化疗的进展期胃癌患者36例,采用TX方案化疗,紫杉醇145mg/m2静脉滴注3h,d1;卡培他滨2000mg/m2,分2次口服,d1-14,21天为一个周期,随访观察疗效,不良反应,进展时间和生存期。结果：36例患者共接受142个周期的化疗,中位化疗周期数4个。全组36例患者中有35例可评价疗效及不良反应,其中8例部分缓解,有效率为22.8%（95%CI：8.2%-37.5%）。中位进展时间和生存时间分别为4.8个月（95%CI：2.9-6.2）和8.1个月（95%CI：6.4-12.7）。Ⅲ/Ⅳ度不良反应主要为骨髓抑制、手足综合征及脱发。结论：紫杉醇联合卡培他滨方案二线治疗进展期胃癌疗效确切,不良反应小,尤其对老年患者耐受性好。

Clinical effect of paclitaxel plus capecitabine in advanced gastric cancer

Objective：To evaluate the efficacy and safety of paclitaxel plus capecitabine in the second-line treatment of patients with advanced gastric cancer failed to platinum chemotherapy.Methods： All 36 cases of patients with advanced gastric cancer failed to the past FP or FOLFOX4 chemotherapy,received TX chemotherapy with paclitaxel 145mg/m2 intravenously 3h,d1;capecitabine 2000 mg /m2,d1-14,with 21 days as one cycle,then assessed therapeutic effect and side effect after two cycles.Results： A total of 36 patients received 142 cycles of chemotherapy,the median number of chemotherapy cycles was 4.35,including eight cases of partial remission,the effective rate was 22.8%（95% CI： 8.2%-37.5%）.The median TTP and OS were 4.8 months（95% CI： 2.9-6.2） and 8.1 months（95% CI： 6.4-12.7）.III/ IV degree of toxicity were mainly bone marrow suppression,hand-foot syndrome and alopecia.Conclusion：Paclitaxel plus capecitabine chemotherapy as second-line treatment of advanced gastric cancer is effective,side effects are well tolera,especially for elderly patients.