紫杉醇联合卡培他滨一线治疗晚期胃癌

目的评价紫杉醇联合卡培他滨一线治疗老年晚期或转移性胃癌的疗效及毒副反应。方法采用紫杉醇80mg／m^2，静脉滴注3h，第1、8天；卡培他滨2000mg／m^2，分两次口服，连用14d，每3周重复，至少连用2周期后评价疗效。结果32例可评价疗效，其中完全缓解1例（3．1％），部分缓解17例（53．1％），稳定10例（31．3％），进展4例（12．5％），有效率RR：56．3％（18／32），中位疾病进展时间：6．2个月，中位生存期11．8个月，1年生存率为43．5％，临床受益率为75％。主要不良反应为骨髓抑制及胃肠道反应，多为Ⅰ度和Ⅱ度毒副反应，其他有肌肉酸痛、脱发、手足综合征等。所有患者无化疗相关死亡。结论紫杉醇联合卡培他滨方案一线治疗老年晚期或转移性胃癌疗效确切，不良反应可耐受，值得进一步临床研究。

Clinical observation of paclitaxel and capecitabine as a first-line combination chemotherapy for advanced gastric cancer

Objective To evaluate the efficacy and toxicities of paclitaxel and capecitabine as first-line therapy in patients with advanced gastric cancer（AGC）. Methods Patients with histologically confirmed unresectable or metastatic AGC were treated with capecitabine 1000 mg/m^2 p. o. twice daily on days 1-14 and paclitaxel 80 mg/m^2 i. v. on day 1 and day8. every 3 weeks until disease progression or unacceptable toxicities. Resuits Between February 2003 and September 2007,32 patients, of median age 63 years （ range = 39 - 75 years） ,were treated with the combination of capecitabine and paclitaxel. After a median 3.7 cycles（ range = 2 - 8 cycles）of chemotherapy,32 were evaluable for toxicity and response. A total of 1 patient showed complete response and 17 showed partial response making the overall response rate 56. 3%. Median time to progression was 6. 2 months and median overall survival was 11.8 months. The most common adverse effects were myelosuppression, gastrointestinal response,the grade 3 or 4 adverse events include neutropaenia（ 15. 6% of patients）and hand-foot syndrome （3. 1% ）. There was no neutropaenic fever or treatment-related deaths. Conclusion Paclitaxel and capecitabine combination chemotherapy was active and highly tolerable as a first-line therapy for AGC.