多西他赛联合顺铂及氟尿嘧啶(DCF)改良方案治疗晚期胃癌疗效观察  

The efficacy of modified docetaxel,cisplatin and 5-fluorouracil combination chemotherapy in advanced gastric cancer

作　　者：周娜[1] 应红艳[1] 宁晓红[1] 周建凤[1] 赵林[1] 

机构地区：[1]北京协和医院肿瘤内科,北京100730

出　　处：《基础医学与临床》2012年第12期1456-1460,共5页Basic and Clinical Medicine

摘　　要：目的研究多西他赛联合顺铂及氟尿嘧啶改良方案(mDCF)治疗晚期胃癌的疗效及安全性。方法 2006年1月起,采用改良DCF方案治疗45例晚期胃癌患者。化疗方案:多西他赛60 mg/m2,d1;顺铂12 mg/m2,d1～5;氟尿嘧啶2 500 mg/m2,持续输注(civ)120 h;每21天一个周期。主要研究终点:无进展生存期(PFS)。次要研究终点:总生存期(OS),总缓解率(ORR)及不良反应。结果接受一线解救化疗患者40例,完全缓解0例(0%),部分缓解7例(17.5%),疾病稳定19例(47.5%),疾病进展14例(35.0%),总缓解率17.5%(95%CI 7.5%～30.0%),疾病控制率65.0%(95%CI 50.0%～77.5%)。中位PFS 5.2个月(95%CI 3.6～6.8月),中位OS 11.0个月(95%CI 6.9～15.1月)。接受二线解救化疗患者5例,疾病稳定3例,疾病进展2例,中位PFS 5.3个月(95%CI 0～11.3月),中位OS 8.5个月(95%CI 0～17.1月)。主要不良反应为血液学毒性,Ⅲ～Ⅳ度粒细胞减少及粒细胞减少伴发热发生率分别为26.7%及11.1%,Ⅲ～Ⅳ度恶心、呕吐及腹泻发生率分别为8.9%、8.9%及11.1%。结论改良DCF方案有效,不良反应可耐受。Objective To assess the efficacy of modified docetaxel,cisplatin and 5-fluorouracil（mDCF） chemotherapy in patients with advanced gastric adenocarcinoma.Methods Since January 2006,45 patients with advanced gastric cancer were enrolled and treated with mDCF protocol.The mDCF protocol included docetaxel 60 mg/m2 on d1,cisplatin 12 mg/m2 on d1-5 and 5-fluorouracil 2 500 mg/m2 continuous infusion（civ） for 120 h,at an interval of 3 weeks.The primary endpoint was progression-free survival（PFS） and the secondary endpoints were overall survival（OS）,response rate（RR） and side effects.Results In 40 patients who received mDCF as first-line palliative chemotherapy,no patient achieved complete response,7（17.5%） had partial response,9（47.5%） had stable disease,and 14（35%） showed progressive disease.Overall response rate was 17.5%（95% CI 7.5%-30.0%）and disease control rate was 65.0%（95% CI 50.0%-77.5%）.Median PFS was 5.2 months（95% CI 3.6-6.8 months）and median OS was 11.0 months（95% CI 6.9-15.1 months）.In 5 patients who received mDCF as second-line palliative chemotherapy,3 achieved stable disease and 2 had progressive disease.Median PFS was 5.3 months（95% CI 0-11.3 months） and median OS was 8.5 months（95% CI 0-17.1 months）.Major side effects were hematologic effects.The rates of grade 3/4 neutropenia,neutropenia with fever,nausea,vomiting and diarrhea were 26.7%,11.1%,8.9%,8.9% and 11.1% respectively.Conclusions The mDCF regimen is effective with a folerable toxicity profile.

关 键 词：晚期胃癌 化疗 多西他赛 顺铂 氟尿嘧啶 

分 类 号：R735.2[医药卫生—肿瘤]