多西紫杉醇联合草酸铂和5-氟尿嘧啶治疗进展期胃癌的疗效分析

目的观察多西紫杉醇联合草酸铂和5-氟尿嘧啶治疗进展期胃癌的临床疗效及不良反应。方法32例进展期胃癌采用多西紫杉醇75 mg/m^2,第1天静脉输注1 h;草酸铂100 mg/m^2,第1天静脉输注3 h;醛氢叶酸0.2 g/m^2,第1天静脉输注2 h;5-氟尿嘧啶2.4 g/m^2用便携式微量输液泵持续静脉输注48 h,21天为1个周期。治疗2个周期后评价疗效和不良反应。结果32例患者均可评价,获得完全缓解（CR）1例、部分缓解（PR）13例、稳定（SD）11例、进展（PD）7例,总有效率（RR）为43.8%（14/32）,中位疾病进展时间（TTP）6.5个月,中位生存期10.1个月。主要不良反应为骨髓抑制、腹泻、四肢末梢感觉异常,其中Ⅱ-Ⅲ度白细胞减少为65.7%（21/32）,Ⅱ-Ⅲ度血小板减少为34.4%（11/32）,Ⅰ-Ⅱ度神经毒性为56.3%（18/32）,Ⅰ-Ⅱ度腹泻为18.8%（6/32）。结论多西紫杉醇联合草酸铂、5-氟尿嘧啶方案治疗进展期胃癌疗效肯定,且毒副反应可以耐受,患者临床受益。

Clinical study of docetaxel, 5-fluorouracil and oxaliplatin combination in the treatment of patients with advanced gastric cancer

Objective To evaluate the efficacy and adverse reactions of combined regimen of docetaxel, 5 - fluorouracil （5 - Fu） and oxaliplatin in the treatment of advanced gastric cancer. Methods 32 patients with advanced gastric cancer were treated with intravenous dripping of docetaxe175 mg/m^2 for 1 hr and oxaliplatin 100 mg/m^2 3 h and intravenous dripping of CF 0.2 g/m2 for 2 h on day 1, coupled with continuous intravenous dripping of 5 - Fu 2.4 g/m^2 with a portable micro - infusion pump for 48 h. The regiment was repeated every 21 days and the clinical response and adverse reactions were recorded after two cycles. Results All the patients could be included for response rate and the overall response rate was 43.8% （14/32） with 1 case of complete response （CR） and 13 of partial response （PR）, 8 of steadiness （SD） and 2 of progressive disease （PD）. Median time to progress （TIP） was 6.5 months, median survival time was 10.1 months. The main adverse reactions were myelosuppression, diarrhea and peripheral paresthesia on the extremities, including 65.7% grade Ⅱ and Ⅲ leucopenia （21/32） and 34.4% thrombocytopenia （11/32）, 56. 1% grade Ⅰand Ⅱneurological toxicity （18/32）, and 18.8% grade Ⅰand Ⅱ diarrhea （6/32）. Conclusion The efficacy of combined regimen of docetaxel, 5 - Fu and oxaliplatin is confirmed clinically for its better effects in the therapy of advanced gastric cancer, with tolerable toxicities and side effects.