紫杉醇联合CF／5-FU治疗晚期胃癌22例临床观察

Clinical study on treating advanced gastric cancer with Paclitaxel/5-FU combined chemotherapy

目的 观察紫杉醇为主联合亚叶酸钙／5-氟尿嘧啶（5-FU）治疗晚期胃癌的疗效及不良反应。方法 化疗方案：紫杉醇（Taxol）＋亚叶酸钙（CF）／5-FU，28d为一个周期，连用2周期后评价疗效。Taxol每周疗法，60mg／m^2加入0．9％生理盐水500mL静滴，不少于3h，d1、d8、d15；CF200mg，d1-d5，5-FU 600mg／m^2，d1-5。结果 全组共完成化疗70周期，22例均可评价疗效，全组1例CR（4．6％），8例PR（36．4％），总有效率40．9％。8例SD（36．4％）；5例PD（22．7％）。毒副作用，主要为骨髓抑制，白细胞减少占81．8％，其中Ⅰ、Ⅱ级占77．3％；脱发占81．8％，均为Ⅰ、Ⅱ级；肌肉节痛占54．5％；其它还包括过敏（4．6％）、腹泻（9．1％）、肝功异常（22．8％）、心电图异常（4．6％）等。但无严重超敏反应，无治疗相关性死亡。结论 晚期胃癌病人使用以紫杉醇为主联合化疗方案具有一定的疗效，毒副反应可以耐受，在晚期胃癌缺乏有效治疗措施的情况下可作为一种较好选择。

Objective To evaluate the efficacy and side effects of Paclitaxel/5-FU combined chemotherapy in advanced gastric cancer. Methods Combined chemotherapy regimen： Taxol ＋ CF/5-FU, Taxol 60mg/m^2 500mL insaline iv gtt, no less than 3hr, d1,d8 and d15. CF 200mg, d1,-d5, 5-FU 600 mg/m^2, dl-5, 28d each cycle. Efficacy was evaluated after 2 cycles. Results Total 70 cycles was accomplished. All 22 cases could be evaluated, which includes 1 CR （4.6%）, 8 PR （36.4%）, 8 SD （36.4%）, 5 PD （22.7%）, and total response rate reached 40.9%. Toxicity included bone marrow suppression, leucopenia was 81.8%, grade I and II reached 77.3%. Alopecia was 81.8%, all was grade I and II. Muscle pain and arthralgia reached 54.5%, allergic reaction was 4.6%. Diarrhea was 9.1%, abnormal liver function was 22.8% and abnormal ECG presentation was 4.6. No severe allergic reaction and therapeutic relative death were found. Conclusion Paclitaxel/5-FU combined chemotherapy is effective, tolerable toxicity, and a good alternative method in treatment of advanced gastric cancer.