多西他赛联合奥沙利铂、氟尿嘧啶和亚叶酸钙方案治疗Ⅲ、Ⅳ期胃癌后再手术的临床疗效初步观察  

Resection of stage Ⅲ and Ⅳ gastric cancer after neoadjuvant chemotherapy with the combination of docetaxel,oxaliplatin fluorouracil and leucovorin

作　　者：周荣平[1] 张有成[1] 陈刚[1] 程顺舟[1] 沈志力[1] 

机构地区：[1]南京医科大学附属江宁医院肿瘤治疗中心,江苏南京211000

出　　处：《南京医科大学学报（自然科学版）》2010年第8期1183-1186,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:探讨多西他塞联合奥沙利铂、氟尿嘧啶和亚叶酸钙治疗Ⅲ、Ⅳ期胃癌后再手术的临床疗效。方法:对2005年1月～2008年8月期间40例Ⅲ、Ⅳ期胃癌患者,第1天应用多西他塞60mg/m2、奥沙利铂75mg/m2;第1～5天氟尿嘧啶500mg/m2、亚叶酸200mg/m2,每4周为1个周期,共2～3个周期,化疗结束4～6周后手术。结果:总有效率70%,病理客观有效率85%,根治性切除率62.5%。主要不良反应:骨髓抑制和恶心、呕吐。没有严重的化疗并发症;疾病进展时间(TTP)6.4个月,中位生存期(MST)20.6个月。结论:多西他塞联合奥沙利铂、氟尿嘧啶和亚叶酸钙方案治疗Ⅲ、Ⅳ期胃癌后再手术可以提高手术的根治率和切除率,并且具有较好的安全性和依从性。Objective：To investigate the clinical effect on resection of stage Ⅲ and Ⅳ gastric cancer after neoadjuvant chemotherapy with the combination of docetaxel,oxaliplatin fluorouracil and leucovorin. Methods：From January,2005 to August, 2008,40 patients with stage Ⅲ and Ⅳ gastric cancer received the neoadjuvant chemotherapy 4～6 weeks before operation. Neoadjuvant chemotherapy regimen consisted of 60 mg / m2 docetaxel（Day 1）,75 mg / m2 oxaliplatin（Day 5）,500 mg / m2 fluorouracil（Day 1 to 5） and 200 mg / m2 leucovorin （Day 1 to 5）administered every 4 weeks for 2～3 cycles before operation. Results：Objective response rates were 70%;Objective pathological response rates were 85%;Total resection rates were 85%;Curative resection rates were 62.5%;TTP was 6.4 months;MST was 20.6 months. Major side effects were myelosuppression,nausea and vomiting. No serious complications were observed. Conclusion：The overall curative resection rates and the compliance were increased in patients with the stage Ⅲ and Ⅳ gastric cancer after the neoadjuvant chemotherapy with the combination of docetaxel,oxaliplatin fluorouracil and leucovorin.

关 键 词：新辅助化疗 晚期胃癌 再手术 

分 类 号：R735.2[医药卫生—肿瘤]