晚期胃癌两种化疗方案的临床疗效比较

【目的】通过比较XELOX方案与DCF方案治疗晚期胃癌的疗效及安全性，探讨其临床应用价值。【方法】将60例经病理学确诊的晚期胃癌患者随机分为XELOX（奥沙利铂、卡培他滨）组和DCF（多西紫杉醇、顺铂、氟尿嘧啶）组各30例，经2个周期（6周）的不同化疗后，比较两组患者的近期疗效、生活质量及毒副反应。【结果】XELOX组安全缓解（CR）2例，部分缓解（PR）14例，有效率为53．33％，DCF组CR2例，PR13例，有效率为50．00％，两组有效率比较差异无显著性（P〉0．05）；XELOX组生活质量（KPS评分）改善率较DCF组明显提高（P〈0．05）；两组主要不良反应为血液、神经毒性及胃肠道反应，其中DCF组的白细胞减少、脱发及恶心呕吐副反应显著高于XELOX组，而XELOX组仅手足综合征高于DCF组，差异均显著性（P〈0．05）。【结论】：两种方案治疗晚期胃癌的近期疗效相近，但XELOX方案用药方便、相对安全、耐受性好，值得临床推荐。

Clinical Comparative Study of XELOX vs DCF Regimen for the Treatment of Advanced GastricCancer

Objective]To explore the clinical application value of XELOX and DCF regimen through com- paring the efficacy and safety of XELOX vs DCF regimen for the treatment of advanced gastric cancer. Meth- ods] A total of 60 patients with advanced gastric cancer diagnosed by pathology and histology were randomly divided into XELOX（oxaliplatin and capecitabine） group and DCF（docetaxel, cisplatin and 5-fluorouracil） group with 30 cases in each group. Short-term effect, quality of life and adverse reaction after 2 cycles of chemotherapy were compared between two groups. Results] In XELOX group, 2 cases were complete remis- sion and 14 cases were partial remission, and the effective rate was 53.33%. In DCF group, 2 cases were com- plete remission and 13 cases were partial remission, and the effective rate was 50%. There was no significant difference in the effective rate between two groups（ P 〉0.05）. Compared with DCF group, the improvement rate of the quality of life（KPS score） in XELOX group obviously increased（ P 〈0.05）. The major adverse re- actions of two groups were the responses of blood, neurotoxicity and gastrointestinal tract. The incidence of leukopenia, hair loss, nausea and vomiting in DCF group were significantly higher than those in XELOX group. But only the incidence of hand-foot syndrome in XELOX group was higher than that in DCF group, and there was significant difference（ P 〈0.05）. ConclusionlShort-term effect of two regimens for the treatment of advanced gastric carcinoma is similar. XELOX regimen is convenient medication, and has relative safety and good tolerance, so it is worthy of being recommended for clinical application.