紫杉醇联合顺铂及氟尿嘧啶治疗晚期胃癌  

Paclitaxel combined with cisplatin and 5-fluorouracil in the treatment of advanced gastric carcinoma

作　　者：钟海均[1] 张沂平[1] 马胜林[1] 应杰儿[1] 杨云山[1] 董勇[1] 

机构地区：[1]浙江省肿瘤医院化疗科,浙江杭州310022

出　　处：《中国癌症杂志》2006年第12期1052-1054,共3页China Oncology

摘　　要：背景与目的：胃癌是我国最常见的恶性肿瘤，早期诊断率很低，多数患者确诊时已是晚期，失去手术根治机会，即使能够手术治疗，术后复发也很高，故药物治疗非常重要，但目前晚期胃癌的化疗效果不佳，尚缺乏公认的、规范高效的方案，因此开发新药、设计新的方案已成为晚期胃癌研究的热点.本研究探讨紫杉醇联合顺铂及氟尿嘧啶治疗晚期胃癌的客观疗效及安全性。方法：紫杉醇（paclitaxel）135mg／m^2，分第1、8天静滴，顺铂（DDP）20mg／（m^2·d）第1～3天静滴，氟尿嘧啶（5-FU）500mg／m^2第1天，静滴2h，以后用5-FU2500mg／m^2泵内持续滴注，持续70h，21～28d为一周期，至少2个周期开始评价疗效，获CR、PR患者一个月后确认，小足2个胤期的以观察毒性.结果：全组CR2例，PR22例，总有效率为51．1％，中位TTP为6．8个月；其中初治有13例，获CR2例，PR6例，总有效率为61．5％，中位TTP为7.1个月；复治患者为36例，可评价疗效的有34例，扶CR0例，PR16例，总有效率为47．1％，中位TTP为6．5个月：而且获得CR和PR的病例，部分病例术后也获得病理组织完全缓解和部分缓解.毒副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：紫杉醇联合顺铂及氟尿嘧啶治疗晚期胃癌疗效肯定，特别对初治患者，毒副反应较轻，患者均能耐受，值得临床进一步扩大研究．Background and purpose： It is well known that the gastric carcinoma is one of the most familiar malignancy in our country, h is difficult to diagnose earlier, so many patients have advanced cancer losing the opportunities to having radical surgery, and even if somenne could have the surgery , the relapse rate is also higher. The chemotherapy is becoming very important . So far the response of advanced gastric carcinoma to chemotherapy is poor , there is no recognized , canonical and effective regimen. Now, finding nev,. regimen and designing new project are turning to be the hotspots in the investigation of advanced gastric carcinoma. We evaluated the efficacy and toxicity of paclitaxel combined with cisplatin and 5-fluorouracil in the treatment of the advanced gastric carcinoma. Methods： The patients were treated with paclitaxel 135mg/m^2 by i.v. gtt on dl, dS, DDP 20mg/m^2/d by i.v. gtt on d1-3, 5-FU 500mg/m^2 by i. v. gtt fnr 2h on dl, then 5- Fu 2500mg/m^2 c. i. v. for 70h , administered every 21 to 28 days. Results： Out of whole group, 2eases achieved CR, 22 cases achieved PR with an ORR of 51.1% and median TTP of 6.8 months; out of 13 cases in primary treatment , 2cases achieved CR, 6 cases achieved PR with an ORR of 61.5% and median TTP of 7.1 months; out of 34 evaluable retreated cases, 0 cases achieved CR, 16 cases achieved PR with an ORR of 47.1% and median ＇FFP of 6.5 months. The main toxicities were hematological toxicties , nausea, vomiting and alopecia of grade Ⅰ -Ⅱ Conclusions： The combination regimen of paclitaxel , cisplatin and 5-fluorouracil is effective and well tolerated for patients with advanced gastric carcinoma, especially for primary treatment cases. It is worthy to have further research.

关 键 词：晚期胃癌 紫杉醇 顺铂 氟尿嘧啶 

分 类 号：R735.2[医药卫生—肿瘤]