多西紫杉醇联合奥沙利铂及氟尿嘧啶治疗晚期胃癌的疗效分析

目的观察多西紫杉醇联合奥沙利铂和5-氟尿嘧啶治疗进展期胃癌的临床疗效及不良反应。方法96例进展期胃癌采用多西紫杉醇75mg/m2,第1d静脉输注1h;奥沙利铂100mg/m2,第1d静脉输注3h;亚叶酸0.2g/m2,第1d静脉输注2h;5-氟尿嘧啶2.4g/m2用便携式微量输液泵持续静脉输注48h,21d为1个周期。治疗2个周期后评价疗效和不良反应。结果96例患者均可评价,获得完全缓解（CR）3例,部分缓解（PR）39例,稳定（SD）33例,进展（PD）21例,总有效率（RR）为43.8%（42/96）,中位疾病进展时间（TTP）7.5个月,中位生存期11.4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%（63/96）,Ⅱ～Ⅲ度血小板减少为34.4%（33/96）,Ⅰ～Ⅱ度神经毒性为56.3%（54/96）,Ⅰ～Ⅱ度腹泻为18.8%（18/96）。结论多西紫杉醇联合奥沙利铂、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 96 patients with advanced gastric cancer were treated with intravenous dripping of docetaxel 75mg/m2 for 1h and oxalip-latin 100mg/m2 3h and intravenous dripping of CF 0.2g/m2 for 2h on day 1,coupled with continuous intravenous dripping of 5-Fu 2.4g/m2 with a portable micro-infusion pump for 48h.The regiment was repeated every 21 days and the clinical response and adversereactions were recorded after two cycles.Results All the patients could be included for response rate and the overall response rate was 43.8%（42/96） with 3 case of complete response（CR） and 39 of partial response（ PR）,33 of steadiness（SD） and 21 of progressive disease（PD）.Median time to progress（TTP） was 7.5 months,median survival time was 11.4 months.The main adverse reactions were myelosuppression,diarrhea and peripheral paresthesia on the extremities,including 65.7% grade Ⅱand Ⅲleucopenia（63/96） and 34.4% thrombocytopenia（33/96）,56.1% grade I and Ⅱneurological toxicity（54/96）,and 18.8% grade I and Ⅱdiarrhea（18/96）.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.