多西他赛为主与奥沙利铂为主一线治疗晚期Lauren分型胃癌的疗效对比

目的 探讨以多西他赛为主的化疗方案与以奥沙利铂为主的化疗方案一线治疗晚期胃癌在Lauren分型中的临床疗效。方法 收集中国人民解放军总医院311例晚期胃癌患者，对有随访结果的199例进行Lauren分型，其中肠型88例，弥漫型105例，混合型6例。一线以多西他赛为主化疗方案的109例，以奥沙利铂为主化疗方案的54例，其他化疗方案36例。中位可评价周期数为4周期，且疗效可评价。结果 在肠型组中以多西他赛为主化疗的客观有效率（ORR）为26.7%，疾病控制率（DCR）为86.7%，中位疾病无进展期（mPFS）为4.50月，中位总生存期（mOS）为15.67月；在肠型组中以奥沙利铂为主化疗的客观有效率（ORR）为15.0%，疾病控制率（DCR）为85.0%，中位疾病无进展期（mPFS）为6.33月，中位总生存期（mOS）为21.50月。在弥漫型组中以多西他赛为主化疗的客观有效率（ORR）为18.9%，疾病控制率（DCR）为67.9%，中位疾病无进展期（mPFS）为2.53月，中位总生存期（mOS）为7.23月；在弥漫型组中以奥沙利铂为主化疗的客观有效率（ORR）为10.7%，疾病控制率（DCR）为67.9%，中位疾病无进展期（mPFS）为3.57月，中位总生存期（mOS）为7.23月。因混合型病例较少，故未列入统计之列。结论 弥漫型胃癌较肠型胃癌的预后差。以多西他赛为主化疗方案和以奥沙利铂为主化疗方案在胃癌Lauren分型的肠型和弥漫型中ORR、DCR、mPFS以及mOS的比较，差异均无统计学意义（P＞0.05）。

Comparison of Docetaxel-based and Oxaliplatin-based First-line Treatment for Advanced Gastric Cancer in Lauren Type

Objective To evaluate the clinical effi cacy of Docetaxel-based and Oxaliplatin-based chemotherapyin the fi rst-line treatment of advanced gastric cancer（AGC）in different Lauren types. Methods Retrospectiveanalysis of 311 AGC cases in PLA hospital was involved. Among them, 199 cases had follow-up results, inwhich, 88 cases were intestinal types, 105 were diffuse types and 6 were mixed types. One hundred and nine and54 cases were treated with Docetaxel-based and Oxaliplatin-based fi rst line chemotherapy, respectively. Other36 cases accepted other regimens. The median evaluated cycles were 4 cycles and the effi ciency were evaluated.Results The overall response rate (ORR) of Docetaxel-based chemotherapy in intestinal-type group was26.7%, the disease control rate (DCR) was 86.7%, the median progression-free survival (mPFS) was 4.50 months,and median overall survival (mOS) was 15.67 months. The ORR of Oxaliplatin-based chemotherapy was 15.0%,the DCR was 85.0%, the mPFS was 6.33 months, and the mOS was 21.50 months. The ORR of Docetaxel-basedchemotherapy in diffuse-type group was 18.9%, the DCR was 67.9%, the mPFS was 2.53 months, and the mOSwas 7.23 months. The ORR of Oxaliplatin-based chemotherapy was 10.7%, the DCR was 67.9%, the mPFSwas 3.57 months, and the mOS was 7.23 months. Considering the number of patients was too small, the data ofmixed type was not analyzed. Conclusion Patients with diffuse-type AGC have poorer prognosis than thosewith intestinal-type. There is no statistically signifi cant difference of ORR, DCR, mPFS and mOS between twodifferent chemotherapy groups of advanced gastric cancer in Lauren type(P > 0.05).