PF方案与FAP方案一线治疗进展期胃癌的临床观察

目的:观察紫杉醇联合氟尿嘧啶(PF方案)与奥沙利铂及表阿霉素联合氟尿嘧啶(FAP方案)一线治疗进展期胃癌的近期疗效和毒副反应。方法:进展期胃癌42例,其中PF方案治疗组22例,具体用法:紫杉醇150 mg/m2静脉滴注3 h,d1;亚叶酸钙120 mg/m2静脉滴注,d1～5;5-氟尿嘧啶350mg/m2静脉滴注,d1～5;21 d为1周期,FAP方案治疗组20例,具体用法:奥沙利铂130 mg/m2静脉滴注2 h,d1;表阿霉素60 mg/m2静脉滴注,d1;亚叶酸钙120 mg/m2静脉滴注,d1～5;5-氟尿嘧啶350 mg/m2静脉滴注,d1～5;21 d为1周期。两组均3周期评价疗效。结果:PF方案和FAP方案的有效率(RR)分别为45.5%和50.0%(P=0.768),总生存时间(OS)分别为14.0个月和13.0个月(χ2=0.014,P=0.905),无进展生存期(PFS)分别为7.0个月和10.0个月(χ2=4.463,P=0.035)。两组方案的恶心呕吐、关节肌肉痛及外周神经毒性反应具有统计学意义(P<0.05),余毒副反应发生率近似。结论:与PF方案相比,FAP方案一线治疗进展期胃癌可延长患者的无进展生存期(PFS),但PF方案患者的耐受性较好。

Clinical observation on combined 5-flurouracil with paclitaxel/oxaliplatin or epirubicin as first-line treatment for advanced gastric cancer

Objective:To observe the efficacy and toxicity of 5-flurouracil/paclitaxel/oxaliplatin(PF regimen) or in combination with epirubicin(FAP regimen) as first-line treatment for advanced gastric cancer. Methods:Forty-two patients with advanced gastric cancer were allocated to groups of PF regimen(n=22) and FAP(n=20).In a typical treatment cycle of 21 days,patients in PF group received intravenous drip of paclitaxel in dose of 150 mg/m2 at day 1 for 3 hours,leucovorin 120 mg/m2 and 5-flurouracil 350 mg/m2 from day 1 to 5,and FAP group were given oxaliplatin in dose of 130 mg/m2(iv gtt) for 2 hours at day 1,epirubicin 60 mg/m2 at day 1,leucovorin 120 mg/m2 and 5-flurouracil 350 mg/m2 from day 1 to 5.The two groups were assessed in individual cycle in 9-week therapy for the efficacy. Results:In two groups of PF and FAP regimen,response rate(RR) was 45.5% and 50.0%(P=0.768);overall survival(OS),14.0 and13.0 months(χ2=0.014;P=0.905);and median progression-free survival(PFS),7.0 and 10.0 months,respectively(χ2=4.463;P=0.035).Although the two groups were different regarding the adverse effects of nausea,sickness and neurotoxicity(P<0.05),other toxicity remained as much. Conclusion:PFS regimen as first-line treatment for advanced gastric cancer can lead to longer PFS,and yet,patients are likely to be better tolerated with PF intervention.