多西他赛不同联合用药方案周剂量治疗晚期胃癌

目的 探讨多西他赛不同联合用药方案周剂量治疗晚期胃癌的临床疗效及安全性.方法 纳入2014年12月至2016年12月收治的胃癌患者70例,随机分为观察组和对照组,每组各35例.对照组治疗方案为多西他赛+顺铂,观察组治疗方案为多西他赛+奥沙利铂.其中多西他赛剂量为35mg/m2,顺铂剂量为60mg/m2,奥沙利铂剂量为120mg/m2,分别于第1、8天静脉滴注,21d为1个化疗周期,共4个周期.比较两组化疗效果和化疗期间不良反应,随访记录两组患者1年总生存率和肿瘤无进展生存率.结果 观察组和对照组总有效率分别为68.57%和60%,两种化疗方案的总体疗效和总有效率均无显著性差异(P>0.05),观察组1年死亡14例,中位生存时间(10.34±0.40)个月,对照组死亡17例,中位生存时间(9.77±0.59)个月.两组间中位无进展生存时间和中位生存时间比较,均无显著性差异(P=0.327,0.743).观察组不良反应总发生率为34.29%,对照组为68.57%,两组化疗不良反应发生率差异显著(P<0.05).结论 多西他赛联合奥沙利铂治疗晚期胃癌疗效肯定,较多西他赛联合顺铂的安全性更高.

Objective To evaluate the efficacy and safety of docetaxel combined with weekly regimen in the treatment of advanced gastric cancer.Methods 70 patients with gastric cancer admitted to our hospital from December 2014 to December 2016 were randomly divided into the observation group and the control group,each with 35 cases.The control group were treated with docetaxel+cisplatin,the observation group were treated with docetaxel+oxaliplatin.The dose of docetaxel was 35mg/m2,cisplatin dose was 60mg/m2,oxaliplatin dose was 120mg/m2,intravenous drip for first days and 8 days,and 21 days for a chemotherapy cycle,a total of 4 cycles.The effects of chemotherapy and adverse reactions during chemotherapy were compared between the two groups,the 1 year overall survival rate and progression free survival rate were recorded in the two groups.Results The total effective rates of the observation group and the control group were 68.57%and 60%respectively,there were no significantly different between the two groups of the overall efficacy and total effective rate(P>0.05),14 cases died of the observation group in 1 year,the median survival time were(10.34±0.40)months,17 cases died of the control group died in 1 year,the median survival time were(9.77±0.59)months.There were no significant difference of the median progression free survival and median survival time between the two groups(P=0.327,0.743).The total incidence of adverse reactions was 34.29%in the observation group,the control group was 68.57%,there was a significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion The docetaxel combined with oxaliplatin is effective in the treatment of advanced gastric cancer,and it has more safety than docetaxel plus cisplatin.