紫杉醇脂质体联合顺铂及5-氟尿嘧啶治疗晚期胃癌的临床观察

目的 探讨紫杉醇脂质体联合小剂量顺铂及5-氟脲嘧啶(5-Fu)治疗晚期胃癌的近期疗效及安全性.方法 紫杉醇脂质体60 mg/m2,第1,8,15天,静滴;顺铂15 mg·m-2·d-1,第1～5天;5-Fu 500 mg·m-2·d-1,持续静脉泵入,第1～5天(共120 h);21 d为1个周期,2个周期后评价疗效和毒副反应.结果 60例晚期胃癌患者中,有59例患者可评价疗效.其中完全缓解(CR)3例,部分缓解(PR)29例,总有效率为54.2%,中位疾病进展时间(TTP)为7.1个月.40例初治患者中,CR 3例,PR 22例,总有效率为62.5%,中位TTp为7.6个月;20例复治患者中,19例患者可评价疗效,PR 7例,总有效率为36.8%,中位TTP为6.3个月.全组不良反应主要为血液学毒性及消化道反应,大部分为Ⅰ、Ⅱ度.结论 紫杉醇脂质体联合顺铂及5-Fu治疗晚期胃癌疗效肯定,特别对初治患者,不良反应轻,患者均能耐受,值得临床进行大样本研究.

Abstract：

Objective To evaluate the efficacy and toxicity of paclitaxel with low-dose cisplatin and 5-fluorouracil continuous infusion in the treatment of advanced gastric carcinoma. Methods The patients were treated with paclitaxel liposome 60 mg/m2 I. V. Gtt on dl, 8, 15, DDP 15 mg · m-2 · D-1 by I. V. Gtt on dl -5, 5-Fu 500 mg · m -2 · d -1 by civ for 120 h, administered every 21 days. Results Out of the whole group, 3 cases achieved CR, 29 cases achieved PR with an ORR of 54.2% and median TTP of 7. 1 months. Out of 40 cases in the primary treatment, 3 cases achieved CR, 22 cases achieved PR with an ORR of 62.5% and median TTP of 7.6 months. Out of 20 evaluable retreated cases, no case achieved CR, 7 cases achieved PR with an ORR of 36. 8% and median TTP 6. 3 months. The main toxicities were hematological toxicities, nausea and vomiting of grade I - II. Conclusion The combination regimen of paclitaxel, lowdose cisplatin and 5-fluorouracil is effective and well tolerated for patients with advanced gastric carcinoma, especially for primary treatment cases. It is worthy of further study.

Weekly regimen of paclitaxel liposome combined with cisplatin and 5-fluorouracil continuous infusion in the treatment of advanced gastric carcinoma

Objective To evaluate the efficacy and toxicity of paclitaxel with low-dose cisplatin and 5-fluorouracil continuous infusion in the treatment of advanced gastric carcinoma. Methods The patients were treated with paclitaxel liposome 60 mg/m2 I. V. Gtt on dl, 8, 15, DDP 15 mg · m-2 · D-1 by I. V. Gtt on dl -5, 5-Fu 500 mg · m -2 · d -1 by civ for 120 h, administered every 21 days. Results Out of the whole group, 3 cases achieved CR, 29 cases achieved PR with an ORR of 54.2% and median TTP of 7. 1 months. Out of 40 cases in the primary treatment, 3 cases achieved CR, 22 cases achieved PR with an ORR of 62.5% and median TTP of 7.6 months. Out of 20 evaluable retreated cases, no case achieved CR, 7 cases achieved PR with an ORR of 36. 8% and median TTP 6. 3 months. The main toxicities were hematological toxicities, nausea and vomiting of grade I - II. Conclusion The combination regimen of paclitaxel, lowdose cisplatin and 5-fluorouracil is effective and well tolerated for patients with advanced gastric carcinoma, especially for primary treatment cases. It is worthy of further study.