多西他赛联合奥沙利铂和5-氟尿嘧啶方案治疗晚期胃癌41例

目的:观察多西他赛联合奥沙利铂和5-氟尿嘧啶(5-Fu)方案治疗晚期胃癌的近期疗效、毒副反应及生存状况。方法:收集2004-2010年我院41例晚期胃癌患者,多西他赛75 mg.m-2(d 1);奥沙利铂130 mg.m-2(d 2);5-Fu 400～500 mg.m-2.d-1,[d 2～d 5或持续泵入96 h(civ 96 h)],每21 d重复1次,至少2个周期。结果:总缓解率(ORR)为26.8%,疾病控制率(DCR)为78.0%。中位无进展生存期(PFS)为5.6个月(95%CI:3.52～7.6),中位总生存(OS)为12.3个月(95%CI:2.7～21.9)。1年生存率为46.3%(19/41);2年生存率为21.9%(9/41);3年生存率为7.3%(3/41)。常见的毒副反应为骨髓抑制(主要为白细胞及中性粒细胞减少)、胃肠道反应(恶心和呕吐)、腹泻和脱发等。结论:多西他赛联合奥沙利铂和5-FU方案治疗晚期胃癌疗效显著,毒副反应可耐受。化疗近期疗效是晚期胃癌PFS和OS的独立预后因素[危害比(HR):3.6;95%CI:1.8～7.3]。

Docetaxel,oxaliplatin and 5-fluorouracil combination chemotherapy in 41 patients with advanced gastric cancer

Objective: To evaluate the efficacy and toxicity of combination therapy of docetaxel,oxaliplatin and 5-fluorouracil in patients with advanced gastric cancer.Methods: Forty-one advanced gastric cancer patients who received docetaxel,oxaliplatin and 5-fluorouracil combination therapy regimen during 2004-2010 were analyzed retrospectively.Docetaxel 75 mg·m-2(d 1),oxaliplatin 130 mg·m-2(d 2) and 5-fluorouracil 400～500 mg·m-2·d-1(d 2～5) were given in a 21-day cycle for at least 2 cycles.Results: The outcomes of the regimen were as follows: overall response rate(ORR) 26.8%,disease control rate(DCR) 78.0%,median progression-free survival(PFS) 5.6 months(95% CI: 3.52～7.6 months),and median overall survival(OS) 12.3 months(95% CI: 2.7～21.9 months).One-year and 2-year survival rates were 46.3% and 21.9%,respectively.The most common adverse effects were bone marrow suppression(mainly leucopenia and neutropenia),gastro-intestinal toxicity(nausea and vomitting) and diarrhea.Alopecia and hepatic function lesion were also noted in a few patients.Conclusion: The combination chemotherapy regimen of docetaxel,oxaliplatin and 5-fluorouracil can be effectively and safely applied to advanced gastric cancer patients.The early response to the regimen was an independent prognostic factor for PFS and OS of advanced gastric cancer patients(HR 3.6;95% CI: 1.8～7.3).