紫杉醇脂质体联合氟尿嘧啶双周治疗进展期胃癌的临床观察

目的：观察紫杉醇脂质体联合氟尿嘧啶、亚叶酸钙双周治疗进展期胃癌的疗效及不良反应。方法采用紫杉醇脂质体100mg/m2静脉滴注,第1天;亚叶酸钙400 mg/m2静脉滴注,第1天;氟尿嘧啶400 mg/m2静脉注射,第1天;氟尿嘧啶3000 mg/m2加入百特化疗泵中维持46小时,第1天;每2周重复。结果：38例均能评价疗效。其中3例获得CR,16例获得PR,RR为50%,15例SD,4例PD;中位TTP为6.4个月;中位OS为11.2个月;1年生存率为44.6%。全组毒副反应较轻,主要为骨髓抑制、黏膜炎、神经毒性、肌肉关节痛及脱发,胃肠道反应多为Ⅰ～Ⅱ度。其中Ⅲ～Ⅳ度毒副反应包括白细胞减少7例,脱发2例,黏膜炎2例。结论：紫杉醇脂质体联合氟尿嘧啶、亚叶酸钙双周治疗晚期进展期胃癌不良反应较DCF方案（多西他赛、顺铂、5-FU）明显降低,近期疗效和远期生存相似,而前者的耐受性和生活质量似乎更佳,提示以紫杉醇替代多西他赛亦是DCF的一种可选的改良方案。

Paclitaxel Liposome Plus Fluorouracil to Cure Advanced Gastric Cancer

Objective: To observe the effects and adverse reaction of paclitaxel liposome combined with fluorouracil,leucovorin biweekly in the treatment of patients with advanced gastric cancer.Methods: Introduction of paclitaxel liposome at 100mg / m 2;calcium folinate at 400mg / m 2;fluorouracil intravenous at 400mg/m 2 and 3000mg / m 2 in Baxter chemotherapy pump for 46 hours on day 1.Each cycle was 2 weeks.Results: 38 patients could be evaluated for efficacy.3 cases achieved CR.16 cases achieved PR.RR was 50%.15 cases was SD,4 cases was PD;The median TTP was 6.4 months;The median OS was 11.2 months and one-year survival rate was 44.6%.The poisonous deputy reaction was light.The mainly were myelosuppression,mucositis,neurotoxicity,muscle and joint pain and alopecia.Gastrointestinal reaction was grade I-II.The grade III-IV toxicity included neutropenia in 7 cases,alopecia in 2 cases,mucositis in 2 cases.Conclusion The adverse reaction of paclitaxel liposome combined with fluorouracil,leucovorin in the treatment of patients with advanced gastric cancer was significantly reduced than DCF(docetaxel,cisplatin,5-FU).The short-term effect and long-term survival are similar,but the tolerance and quality of life seems to be better in the former.It prompts that Taxol alternative docetaxel is also a DCF optional improvement scheme.