紫杉醇脂质体联合奥沙利铂、氟尿嘧啶治疗晚期胃癌

目的]观察紫杉醇脂质体联合奥沙利铂、氟尿嘧啶方案(POF)治疗晚期胃癌的临床疗效和不良反应。方法]对48例晚期胃癌患者采用POF方案治疗,具体用法:紫杉醇脂质体135mg/m2,第1d静滴3h;奥沙利铂135mg/m2,第2d静滴2h;氟尿嘧啶500mg/m2,化疗泵内持续推注,d1～5。21d为1个周期,每2个周期评价疗效。结果]48例患者均可评价疗效及毒性,其中完全缓解(CR)2例(4.2%),部分缓解(PR)23例(47.9%),稳定(SD)14例(29.2%),进展(PD)9例,总有效率(RR)52.1%,中位疾病进展时间(TTP)6.2个月,中位生存时间(MST)11.5个月。临床受益反应评价总有效率75.0%(36/48)。不良反应主要是骨髓抑制和消化道反应,Ⅲ～Ⅳ度骨髓抑制发生率为22.9%;其他外周神经毒性、肌肉酸痛、脱发,多为Ⅰ～Ⅱ度;无化疗相关性死亡病例。结论]紫杉醇脂质体联合奥沙利铂、氟尿嘧啶(POF)治疗晚期胃癌的疗效确切,不良反应患者能够耐受,可以作为晚期胃癌的一线或二线治疗方案。

Paclitaxel Liposome Combined with Oxaliplation and Fluorouacil Chemotherapy for Advanced Gastric Cancer

Purpose] To investigate the clinical efficacy and toxicity of paclitaxel liposome combined with oxaliplatin and fluorouacil(POF) chemotherapy for advanced gastric cancer.Methods] Forty-eight cases with advanced gastric cancer were treated with POF regimen:paclitaxel liposome 135mg/m 2 iv 3h d 1,oxaliplatin 135mg/m 2 iv 2h d 2,fluorouacil 500mg/m 2 civ d 1 ～5,21d as a cycle.The treatment efficacy was evaluated after two cycles.Results] Fortyeight patients were evaluated.Complete response(CR) occurred in 2 cases(4.2%);partial response(PR),23 cases(47.9%);stable disease(SD),14 cases(29.2%);and progression disease(PD),9 cases,and overall response rate(RR),52.1%.The median time to progression(TTP) was 6.2 months;and the median survival time(MST),11.5 months.The clinical benefit response was 75.0%(36/48).The main toxicities were myelosuppression and digestive tract toxicity,including Ⅲ～Ⅳ degree myelosuppression(22.9%).Others toxicities included peripheral neurotoxicity,muscle aches and hair loss,mostly withⅠ～Ⅱ degree.No chemotherapy related death occurred.Conclusion] Paclitaxel liposome combined with oxaliplatin and fluorouacil(POF) chemotherapy is effective and well tolerated as the first or second line regimen for patients with advanced gastric cancer.