多西紫杉醇联合顺铂、5-氟尿嘧啶治疗晚期胃癌34例临床分析  

Clinical observation of docetaxel combined with cisplatin and 5-fluorouracil in the treatment of advanced gastric cancer

作　　者：程梅莲[1] 顾汉刚[1] 李小琴[1] 

机构地区：[1]江苏大学附属医院化疗科,江苏镇江212001

出　　处：《现代肿瘤医学》2009年第4期707-709,共3页Journal of Modern Oncology

摘　　要：目的:评价多西紫杉醇联合顺铂、5-氟尿嘧啶方案(DCF方案)治疗晚期胃癌的临床疗效和不良反应。方法:DCF方案治疗晚期胃癌患者37例。多西紫杉醇45mg/m2,静滴1h,d1、8;5-氟尿嘧啶(5-FU)375mg/m2,持续静脉泵(Graseby泵)点滴24h,d1-5;顺铂20mg/m2,d1-5;28天为1个周期。用药至少2个周期后评价疗效和不良反应。结果:全组34例可评价疗效,完全缓解(CR)1例,部分缓解(PR)14例,稳定(SD)15例,进展(PD)4例,有效率(RR)为44.1%。中位进展时间(TTP)为6.1个月,中位生存期为9.3个月,1年生存率28.2%。其中初治组有效率为52.6%(10/19),有1例CR;复治组有效率为33.3%(5/15),无CR病例,两组无显著差异(P>0.05)。不良反应主要为骨髓抑制、消化系反应和脱发。大部分患者为Ⅰ、Ⅱ度反应,耐受良好。其中白细胞减少27例(79.4%),Ⅲ-Ⅳ度8例(23.5%)。结论:多西紫杉醇联合顺铂、5-氟尿嘧啶组成DCF方案治疗进展期胃癌疗效较好,不良反应可以耐受,值得临床进一步探讨。Objective：To evaluate the efficiency and toxicity of docetaxel combined with 5 -fluorouracil and cisplatin （DCF） regimen in patients with advanced gastric cancer. Methods：Thirty - seven patients with advanced gastric cancer diagnosed pathologically were enrolled into the study. The patients received docetaxel 45 mg/m^2 on day 1,8 ;5 - FU 375 mg/m^2 infused with an ambulatory pump on day 1 to 5 ; and cisplatin 20mg/m^2 on day 1 to 5,repeated every 28 days at least 2 courses. All patients were assessable for toxicity and response to treatment. Results ： Three complete responses and fourteen partial responses were observed. Stable disease was observed in fifteen patients, with progressive disease in the other four patients overall response rate was 44.1%. Median time to progression （TTP） and median overall survival （OS） were 6.1 and 9.3 months,respectively. The one year survival rate was 28.2%. No significant difference existed between the initial and retreated patients （RR, 52.6% vs 33.3% , P 〉 0.05 ）. The most common toxicities were myelosuppression,nausea/vomiting and alopecia. The severity of these side effects were grade Ⅰ - Ⅱ , and well tolerated. Myelosuppression was dose limiting toxicity, grade Ⅲ - Ⅳ hypolekocytosis was 23.5 % （8/34） and 79.4% （27/34） in total. Conclusion： Docetaxel combined with cisplatin and 5 -fluorouracil is a safe and effective regimen in the treatment of advanced gastric cancer. The toxicity and side effects are tolerable.

关 键 词：多西他赛 顺铂 5-氟尿嘧啶 晚期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]