多西紫杉醇联合奥沙利铂、卡培他滨与FOL FOX4 方案治疗晚期胃癌疗效比较

 目的 观察多西紫杉醇联合奥沙利铂、卡培他滨方案与FOLFOX4方案治疗晚期胃癌的客观疗效，疾病进展时间和毒性反应。方法 治疗组41例晚期胃癌患者接受多西紫杉醇25mg／m²（d1，d8，d15），奥沙利铂60mg／m^2（d1，d8，d15），卡培他滨每日1250mg／m²，分2次口服，d1～14，28d为1周期，疗程2～6周期。对照组40例晚期胃癌患者接受奥沙利铂85mg／m^2d1，亚叶酸钙200mg／m²（2h静脉输注）d1-d2，而后5-Fu400mg／m²（10min静脉推注）及5-Fu600mg／m²（持续静脉泵入22h），d1～d2，每14d重复，2次为1周期。结果 多西紫杉醇联合奥沙利铂、卡培他滨方案治疗组总有效率为58．5％，中位疾病进展时间（TTP）为6．8个月。常见的毒性反应为白细胞和中性粒细胞减低，手足综合征和周围神经毒性反应等。FOLFOX4方案总有效率为47．4％，中位TTP为5．9个月。常见的毒性反应为白细胞和中性粒细胞减低和周围神经毒性反应等。结论 多西紫杉醇联合奥沙利铂、卡培他滨化疗方案治疗晚期胃癌近期疗效显著，耐受性较好。

Clinical Comparison of Docetaxel/Oxaliplatin/Capecitabine and Folfox 4 in Treating Advanced Gastric Cancer

Objective To evaluate the objective response rate,time to progression(TTP)and toxicity between Docetaxel/Oxaliplatin/Capecitabine and Folfox 4 in the treatment for the advanced gastric cancer.Methods Forty-one patients with advanced gastric cancer were administrated with Docetaxel 25 mg/m2(d1,d8,d15),Oxaliplatin 60 mg/m2(d1,d8,d15),and Capecitabine 1 250 mg/m2/d divided in two daily doses given from d1 to d14.The cycles were repeated every 28 days.All patients received two to six cycles.The other 40 patients with advanced gastric cancer were administrated with Oxaliplatin(85 mg/m2,ivgtt,d1)combined with Leucovorin(200 mg/m2,ivgtt;d1 to d2),Fluorouraci1(400 mg/m2,iv,followed by 5-Fu 600 mg/m2 continuous venous infusion 22 hours,dl to d2),repeated every 14 days,twice for one recycle.The treatment was finished after 2 recycles.Results The outcomes the regimen was as follows:The total response rate in Docetaxel/Oxaliplatin/Capecitabine was 51.6 %,The most common adverse effects were leucopenia,neutropenia,hand foot syndrome and peripheral neuropathy.The response rate in Folfox4 was 47.4%,The most common adverse effects were leucopenia,neutropenia,and peripheral neuropathy.The median TTP of primary and secondary treatment were 6.8 months and 5.9 months respectively.Conclusion The Docetaxel/Oxaliplatin/Capecitabine regimen offers a better therapeutic option in patients with advanced gastric cancer.