紫杉醇脂质体联合大剂量5-FU持续静脉滴注治疗进展期胃癌的临床疗效

目的评估紫杉醇脂质体联合大剂量5-氟尿嘧啶（5-Fu）持续静脉滴注治疗进展期胃癌的疗效和不良反应。方法选择我院普外科2009年5月至2012年8月期间收治的63例进展期胃癌患者，给予紫杉醇脂质体联合大剂量（2．5g／m^2）5-FU持续静脉滴注治疗。依据RECIST标准进行疗效评价，并观察该化疗方案的不良反应。结果无一例患者因严重化疗毒性反应不能耐受而终止治疗。63例患者中达到完全缓解5例（7．94％），部分缓解31例（49．2％），总体有效率为57．1％（36／63）。血液学毒性反应中Ⅲ／Ⅳ级白细胞减少、中性粒细胞减少分别为8例（12．7％）和10例（15．9％），没有发生Ⅲ／Ⅳ级的贫血或血小板减少。非血液学毒性反应相对较轻，基本为Ⅰ／Ⅱ级反应。结论紫杉醇脂质体具有安全性高、耐受性好、靶向性高和长时疗效的特点。紫杉醇脂质体联合大剂量5-FU持续静脉滴注治疗进展期胃癌临床疗效确切、不良反应较轻、患者耐受性好。

Clinical Evaluation of Paclitaxel Liposome Combined with Continuous Intravenous Infusion of Large-Dose 5-Fluor- ouraeil as First-Line Chemotherapy for Advanced Gastric Cancer

Objective To evaluate the therapeutic effect and adverse reaction of paclitaxel liposome combined with continuous infusion of large-dose 5-fluorouracil （5-FU） in treatment for advance gastric cancer （AGC）. Methods From May 2009 to August 2012, 63 consecutive patients with AGC in this hospital were enrolled in this study. All the patients were given chemotherapy including paclitaxel liposome and continuous infusion of large-dose （2. 5 g/m^2） 5-FU. The efficacy and toxicity of this regimen were observed. Results There was no patient who could not tolerate adverse reaction related to such regimen. Five cases achieved complete response and 31 cases achieved partial response, the overall response rate was 57. 1% （36/63）. Hematologic toxicity included grade Ⅲ/Ⅳ leucopenia 8 cases （12.7%） and nentropenia 10 cases （15.9%）, while there was no occurrence of grade Ⅲ/Ⅳ anemia or thrombopenia. Non-hematologic toxicity was fairly mild. Conclusions Paclitaxel liposome is safe, well tolerated, highly targeted, and has long duration of effect. Paclitaxel liposome combined with continuous infusion of large-dose 5-FU is safe and effective in treatment for patients with AGC.