改良DCF 方案一线治疗晚期胃癌患者的临床观察

目的：观察改良DCF方案（多西紫杉醇+顺铂+5-氟尿嘧啶）一线治疗晚期胃癌的疗效及不良反应。方法：对2008年6月—2011年6月收治的48例初治晚期胃癌患者，采用改良DCF方案化疗，即多西紫杉醇75 mg/m2静脉滴注（第1天），顺铂20 mg/m2静脉滴注（第1~3天），5-氟尿嘧啶750 mg/m2持续静脉滴注24 h（第1~5天）。21 d为1周期，至少2周期后进行疗效评价。结果：随访日期截止2013年2月，无失访病例。全组患者总有效率（ORR）为29.2%（14/48），疾病控制率（DCR）为87.5%（42/48），其中完全缓解（CR）1例（2.1%），部分缓解（PR）13例（27.1%），病情稳定（SD）28例（58.3%），病情进展（PD）6例（12.5%）；中位疾病进展时间（TTP）为6.9个月，中位总生存期（OS）为12.5个月；不良反应为主要为骨髓抑制、消化道反应和脱发，粒细胞减低发生率为66.7%（32/48），其中III~IV度占21.8%（7/32），血小板减低发生率为20.8%（10/48），无III~IV度发生者；无严重感染、出血等治疗相关死亡。化疗后KPS评分是独立的预后影响指标。结论：改良DCF方案一线治疗晚期胃癌疗效确切，耐受性好。

Clinical observation of modified dCF regimen for first-line treatment of advanced stomach cancer

Objective: To evaluate the efficacy and adverse reactions of the modified DCF regimen for first-line therapy of advanced gastric cancer. Methods: During June 2008 to June 2011, 48 primarily treated patients with advanced gastric cancer underwent the DCF regimen that consisted of docetaxel (75 mg/m2 intravenous drip on day 1), cisplatin (20 mg/m2/day intravenous drip on day 1 to 3), and 5-fluorouracil (750 mg/m2/day continuous intravenous infusion on day 1 to 5). Every 21 d constituted one cycle of treatment, and at least two cycles were required for efficacy evaluation.Results: The deadline of follow-up was February 2013, and no patient was lost to follow-up. In the entire group of patients, the overall response rate (ORR) was 29.2% (14/48) and disease control rate (DCR) was 87.5%, while specifically, complete remission (CR) was achieved in one case (2.1%), partial remission (PR) was obtained in 13 cases (27.1%), stable disease (SD) was seen in 28 cases (58.3%), and disease progression (PD) occurred in 6 cases (12.5%). The median time to progression (TTP) was 6.9 months and median overall survival (OS) was 12.5 months, respectively. The major adverse events were myelosuppression, gastrointestinal reactions and alopecia, and the incidence of granulocytopenia was 66.7% (32/48) with III-IV degree accounting for 21.8 (7/32), and thrombocytopenia was 20.8% (10/48) with III-IV degree; no treatment-related death such as serious infection or bleeding occurred. Post-chemotherapy KPS score was an independent influential indicator for prognosis.Conclusion: Modified DCF regimen for first-line therapy of advanced gastric cancer shows definite efficacy and good tolerance.