周剂量多西他赛联合顺铂和低剂量氟尿嘧啶治疗晚期胃癌的临床观察  

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

作　　者：王妹兴[1] 陶莉[1] 成少华[1] 谭越[1] 肖谜[1] 郑鸿[1] 

机构地区：[1]复旦大学附属肿瘤医院闵行分院,上海200240

出　　处：《中国肿瘤临床与康复》2013年第3期229-231,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨周剂量多西他赛(docetaxe1,TXT)、顺铂(cisplatin,DDP)联合低剂量5-氟尿嘧啶持续滴注对晚期胃癌的疗效。方法 36例晚期胃癌患者中,20例为初治者(初治组),16例为复治者(复治组)。所有患者均采用多西他赛40mg/m2静脉滴注1h,第1、8天;顺铂20mg/m2静脉滴注,第1、2、8、9天;5-氟尿嘧啶1.25g/m2,第1、2、8、9天,持续静脉泵(Baxter泵)点滴共96h。21d为1个周期,至少2个周期后评价疗效。结果 36例患者中,32例可评价疗效,完全缓解(CR)l例,部分缓解(PR)l4例,稳定(SD)13例,进展(PD)4例,总有效率(RR)为46.8%。中位进展时间(TTP)为5.8个月,中位生存时间为8.3个月,1年生存率为15.6%。其中初治组有效率为55.6%(10/18),有1例CR;复治组有效率为35.7%(5/14),无CR病例,两组差异无统计学意义(P>0.05)。不良反应主要为骨髓抑制、消化道反应和脱发。大部分患者为I、Ⅱ度反应,耐受性良好。其中白细胞减少23例(63.9%),Ⅲ-Ⅳ度6例(16.7%)。结论多西他赛联合顺铂和5-氟尿嘧啶组成DCF方案周治疗进展期胃癌疗效较好,不良反应可以耐受,值得进一步探讨。Objective To investigate the efficacy of weekly docetaxel（TXT）,cisplatin（DDP） combined with continuous infusion of low dose fluorouraeil（FU） on advanced gastric carcinoma.Methods 36 patients with advanced gastric cancer diagnosed pathologically were enrolled into the study.The patients received docetaxel 40 mg/m2 on day 1,8;cisplatin 20mg/m2 on day 1、2,8、9,and 5-Fu 1.25g/m2 infused with an ambulatory pump on day 1、2,8、9,continuous 96h,repeated every 21 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 thirteen patients,with progressive disease in the other four patients,the overall response rate was 46.8%.Median time to progression（TTP） and median overall survival（OS）were 5.8 and 8.3 months,respectively.The one year survival rate was 15.6%.No significant difference existed between the initial and retreated patients（RR,55.5% vs 35.7%,P0.05）.The most common toxicities were myelosuppression,nausea,vomiting and alopecia.The severity of these side effects were grade I-Ⅱ,and well tolerated.The grade Ⅲ-Ⅳ and hypolekocytosis were 16.7%（6/36）and 63.9%（23/36）in tota1.Conclusions The DCF（Docetaxel combined with cisplatin and 5-fluorouracil） plan is safe and effective.

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]