多西他赛联合替吉奥治疗晚期胃癌的回顾性评价  

Retrospective evaluation of DT regimen in treatment of advanced gastric cancer

作　　者：刘险峰[1] 华云旗[1] 杨永岩[1] 毋永娟[1] 

机构地区：[1]包头市肿瘤医院肿瘤内科一病区,内蒙古包头014030

出　　处：《临床荟萃》2013年第9期963-966,共4页Clinical Focus

摘　　要：目的比较多西他赛联合国产替吉奥（维康达）和其他化疗方案治疗晚期胃癌的疗效及不良反应，探讨晚期胃癌的合理治疗。方法回顾性分析2009年6月至2011年4月89例晚期胃癌的治疗情况，根据患者接受治疗方案不同分为3组。多西他赛联合替吉奥组（DT组）：多西他赛75mg／m2，第1天，替吉奥80mg／m2，分两次饭后口服，第1～14天，21天为1个周期；常规化疗组：多西他赛75mg／m2，第1天，奥沙利铂130mg／m2，第2天（DO组），或顺铂（70mg／m2，第2天）＋5-氟尿嘧啶2．5g／m2，46小时持续泵入（DCF组），21天为1个周期；记录I临床近期疗效及不良反应，观察3个周期后进行统计分析。结果DO组、DCF组、DT组中位无进展生存（PFS）分别为4．8、11．4、12．5个月，3组患者中位PFS比较，差异有统计学意义（P〈0．05）。89例患者均可评价疗效，DT组疾病控制率为58．1％（18／31），DO组为46．4％（13／28），DCF组为53．3％（16／30），3组比较差异无统计学意义（P〉0．05），临床有效率3组间差异亦无统计学意义（P〉0．05），DT组不良反应主要为恶心、腹泻和骨髓抑制等，D0和DCF组不良反应主要为骨髓抑制、胃肠道反应和手足综合征等，DT组不良反应明显低于其他两组（P〈0．05）。结论多西他赛联合替吉奥治疗晚期胃癌具有较高的t临床有效率，不良反应较轻，尤其是身体状况较差的晚期老年患者。Objective This study intends to compare docetaxel combined Wei Kang Da and other chemotherapy in the treatment of advanced gastric cancer for efficacy and toxicity;rational treatment. Methods Eighty-nine cases of advanced gastric cancer with different treatments from June 2009 to April 2011 in our hospital were retrospectively analyzed. The patients were divided into three groups according to different regimens ： docetaxel combined for Wei Kang Da group （DT group） and DO/DCF group. DT group：received Wei Kang Da 80 mg/m2 ,orally during the meal twice a day,dl-14,docetaxel 75 mg/m2 ,dl,21 day for a cycle;conventional chemotherapy：DO/DCF group,21 day for a cycle, docetaxel （75 mg/m2 ,dl） ＋ oxaliplatin （130 mg/m2 ,d2） or cisplatin （70 mg/m2 ,d2） and 5-fluorouracil （2.5 g/m2 , 46-hour continuous infusion）. The clinical efficacy and toxicity were observed after three cycles. Results The median of progression-free survival in groups DO, DCF, DT were 4.8,11.4, 12.5 months, respectively, there were significant difference in the comparisons（ P d0.05）. Totally 89 patients were evaluated for efficacy. In DT group, the disease control rate was 58.1; （18/31）,in DO group,it was 46.4; （13/28） ,DCF group,53.3; （16/30） , three groups showed no significance in comparison（ P 〉0.05） ,the clinical efficiency of three groups also showed no statistic significance（ P 〉0.05）. The main toxicities of DT group were such as nausea,diarrhea,and bone marrow suppression,and the main toxicities of DO and DCF groups were bone marrow suppression,gastrointestinal reactions and hand-foot syndrome and others. The side effects were significantly less in DT group compared with the other two groups （ P〈 0.05）. Conclusion The regimen of docetaxel combined Wei Kang Da in the treatment of advanced gastric cancer shows high clinical efficacy, less toxicity, especially in poor physical condition of elderly patients.

关 键 词：胃肿瘤 抗肿瘤联合化疗方案 多西他赛 奥沙利铂 5-氟尿嘧啶 

分 类 号：R735.2[医药卫生—肿瘤]