ECF与DOF方案治疗晚期胃癌的临床疗效观察

目的：观察ECF方案（表柔比星联合顺铂、氟尿嘧啶）和DOF方案（多西他赛联合奥沙利铂、氟尿嘧啶）治疗晚期胃癌的临床疗效和不良反应。方法将68例确诊为晚期胃癌患者分为两组，其中ECF组30例，DOF组38例，ECF方案：表柔比星50mg／m2第1天，顺铂20mg／m2第1～3天，氟尿嘧啶500mg／m2第1～5天；DOF方案：多西他赛75mg／m2第1天，奥铂130mg／m2第1天，氟尿嘧啶500mg／m2第1～5天。21d为1个周期，两组均治疗2个周期以上。根据WHO的标准评价其有效性和毒性。结果68例患者均可评价疗效，ECF组有效率为46．67％（14／30），DOF组有效率为42．11％（16／38）。不良反应主要为骨髓抑制、胃肠道反应、脱发、神经毒性等，DOF组神经毒性发生率39．47％（15／38）高于ECF组的13．33％（4／30），ECF组恶心呕吐发生率93．33％（28／30）高于DOF组的68．42％（26／38），两组比较差异有统计学意义（P＜0．05）。结论ECF方案与DOF方案对晚期胃癌的疗效相似，不良反应可以耐受。

Observation on clinical effect of ECF regimen and DOF regimen in treating advanced gastric cancer

Objective To observe the efficacy and adverse reactions of ECF regimen (epirubicin combined with cisplatinum and fluorouracil) and DOF regimen (docetaxel combined with oxaliplation and fluorouracil ) in the treatment of advanced gastric cancer .Methods 68 cases of advanced gastric cancer were randomly divided into the ECF group (30 cases) and the DOF group (38 cases) .The ECF group was treated with epirubicin 50 mg/m2 on 1 d ,cisplatin 20 mg/m2 on 1-3 d and fluorouracil 500 mg/m2 on 1-5 d .The DOF group was treated with docetaxel 75 mg/m2 on 1 d ,oxaliplatin 130 mg/m2 and fluorouracil 500 mg/m2 on 1-5 d . 21 d were as a cycle of treatment .All cases received two cycles of chemotherapy at least .The efficacy and toxicity were evaluated according to the WHO standard .Results All cases were evaluable for the objective response .The overall response rate was 46 .67% in the ECF group and 42 .11% in the DOF group .The major adverse reactions in the two groups were marrow depression , gastrointestinal reaction ,alopecia and neurotoxicity ,etc .The occurrence rate of neurotoxicity in the DOX group was 39 .47% (26/38) ,which was higher than 13 .33(4/30) in the ECF group ,the occurrence rate of nausea and vomiting in the ECF group was 93 .33% (28/30) ,which was higher than 68 .24(26/38) in the DOF group ,the difference between the two groups was statistically significant (P<0 .05) .Conclusion Both of the two regimens have the similar effect for treating advanced gastric cancer and the ad‐verse reactions are tolerable .