紫杉醇与多西紫杉醇分别联合顺铂及氟脲嘧啶治疗晚期胃癌的疗效比较

目的比较两种紫杉烷类（紫杉醇、多西紫杉醇）化疗药物分别联合顺铂及氟脲嘧啶治疗晚期胃癌患者的疗效及安全性。方法 48例病理为胃腺癌的Ⅳ期患者,随机分入两组：DCF组25例,TCF组23例。DCF组用药为多西紫杉醇（国产）40mg/m2第1,8天＋氟脲嘧啶500mg/m2第1～5天＋顺铂20mg/m2第1～5天,每三周重复;TCF组用药为紫杉醇（国产）85mg/m2第1,8天＋氟脲嘧啶500mg/m2第1～5天＋顺铂20mg/m2第1～5天,每三周重复。每两周期进行疗效及毒性评价,并进行无疾病进展生存期（PFS）统计。结果 DCF组完全缓解（CR）1例（4.0%）,部分缓解（PR）11例（44.0%）,总有效率48.0%,PFS6.2个月;TCF组CR1例（4.3%）,PR12例（52.2%）,总有效率为56.5%,PFS5.9个月,总有效率、PFS两组差异均无统计学意义。3～4级血液学不良反应：TCF组39.1%,DCF组72.0%,有显著性差异;3～4级非血液学毒性主要为恶心/呕吐,DCF组4例（16.0%）,TCF组5例（21.7%）,差异无统计学意义。其他少见毒性,包括DCF组腹泻1例（4.0%）,TCF组周围神经病变1例（4.3%）。结论紫杉醇与多西紫杉醇联合氟脲嘧啶、顺铂治疗晚期胃癌疗效相近,毒性不尽相同,但均可耐受。

Paclitaxel versus Docetaxel Combined with 5-FU and Cisplatin in Advanced Gastric Cancer

Objective To compared efficacy and safety of two taxanes（paclitaxel and docetaxel） combined with 5-fluorouracil（5-FU） and cisplatin in advanced gastric cancer.Methods 48 patients with staging Ⅳ gastric adenocarcinoma.Randomly divided into two groups：25 patients in DCF group,23 patients in TCF group.Patients in DCF group were treated with docetaxel 40 mg/m2 on days 1,8 plus 5-FU 500 mg/m2 days 1-5 and cisplatin 20 mg/m2 days 1-5,repeated every three weeks;patients in TCF group were treated with paclitaxel 85 mg/m2 on days 1,8 plus 5-FU 500 mg/m2 days 1-5 and cisplatin 20 mg/m2 days 1-5,The chemotherapy in both groups were repeated every 3 weeks.Results In DCF group,1 patients（4.0%） achieved complete response,11 patients（44.0%） had partial response with an overall response rate（ORR） of 48.0% and a PFS 6.2 of months;In TCF group,1 patient（4.3%） achieved complete response,and 12 patients（52.2%） achieved partial response,with an overall response rate of 56.5% and a PFS 5.9 of months,The ORRs and PFS were not significantly different between the 2 groups.Grade 3-4 hematologic toxicities were 39.1% in TCF group,and 72.0% in DCF group,the difference was statistically significant;Nausea/vomiting was the main grade 3-4 non-hematological toxicity,occurred in 4 patients（16.0%） in DCF group,and 5 patients（21.7%） in TCF group.Other rare toxicities including diarrhea occurred in 1 patient（4.0%） in DCF group,peripheral neuropathy occurred in 1 patient（4.3%） in TCF group.Conclusion Two taxanes（paclitaxel and docetaxel） plus 5-FU and cisplatin have similar efficacy in the treatment of advanced gastric cancer with tolerable but different toxicities.