脂质体紫杉醇联合顺铂及氟尿嘧啶一线治疗43例晚期胃癌的临床研究

目的]评价脂质体紫杉醇（力扑素）联合顺铂、氟尿嘧啶（5-Fu）组成的PCF方案一线治疗43例晚期胃癌的临床疗效和毒副反应。方法]脂质体紫杉醇135～175mg/m2,静滴3h,d1;顺铂20mg/m2,静滴2h,d1～5;5-Fu750mg/m2持续静脉滴注d1～5。21d为1个周期。按RECIST标准评定疗效,按WHO标准评价毒副反应,Kaplan-Meier法绘制生存曲线。结果]全组共完成化疗167个周期,中位治疗3个周期。39例患者完成2个周期以上化疗并可评价疗效,其中CR1例,PR19例,SD11例,PD8例,总有效率51.3%。中位无进展生存时间6.0个月,中位总生存时间11.5个月,1年生存率41.0%。主要的Ⅲ~Ⅳ级血液学毒性为白细胞减少及中性粒细胞减少,发生率分别为16.2%和25.6%。全组仅1例发生过敏反应。无患者因毒性反应而停药,无治疗相关性死亡发生。结论]脂质体紫杉醇联合顺铂及氟尿嘧啶一线治疗晚期胃癌疗效肯定,毒副反应轻,对患者生活质量改善明显。

Clinical Study of Paclitaxel Liposome Combined with Cisplatin and 5-Fu as First Line Chemotherapy for 43 Cases with Advanced Gastric Cancer

Purpose] To evaluate the efficacy and toxicity of PCF regimen （paclitaxel liposome combined with cisplatin and 5-Fu） as first line chemotherapy for 43 cases with advanced gastric cancer. Methods] PCF regimen was given as follow： paclitaxel liposome 135~175mg/m2, ivgtt, d1; cisplatin 20mg/m2, ivgtt, d1～5; 5-fluorouracil 750mg/m2 continuous infusion ivgtt, d1～5. Every 21 days was a cycle. Treatment efficacy was evaluated according to RECIST standard and the toxicity was assessed based on the WHO standard. The Kaplan-Meier was used to calculate the PFS and OS. Results] One hundred and sixty-seven cycles of chemotherapy were given for the whole group （median 3 cycles）, 39 cases received ≥2 cycles and were evaluable for efficacy. The overall response rate was 51.3%, 1 case in CR, 19 cases in PR, 11 cases in SD and 8 cases in PD. The median progression free survival was 6.0 months, median over survival was 11.5 months and the 1-year survival rate was 41.0%. The main Grade Ⅲ/Ⅳ hematologic toxicities were hypoleucocytosis and neutropenia, and were found in 16.2% and 25.6% patients, respectively. Only one case experienced allergic reaction. No patient withdrew from the treatment due to the toxicity and treatment- related death was not found. Conclusion] Paclitaxel liposome combined with cisplatin and 5-Fu as first line chemotherapy for advanced gastric cancer is effective, tolerable, and can improve the quality of life.