晚期胃癌不同化学治疗方案的疗效比较

Effect of different chemotherapy regimen for advanced gastric carcinoma

目的观察泰素+氟尿嘧啶(TF)方案和草酸铂+四氢叶酸钙+脱氧氟尿苷(OLD)方案治疗晚期胃癌的近期疗效。方法将经病理检查证实为晚期胃癌的患者117例随机分为TF组(51例)和OLD组(66例)。28d为1个化疗周期,至少接受2个化疗周期。结果TF组初治病例有效率为62.5%,复治病例有效率为59.3%,总有效率为60.8%;OLD组分别为54.8%,31.4%,42.4%。两组初治病例有效率比较差异无显著性(P>0.05),复治病例有效率及总有效率比较差异均有显著性(均为P<0.05)。TF组中位无进展时间8.7个月、中位生存时间19个月;OLD组分别为7.6个月和17.8个月;两组比较差异均无显著性(均为P>0.05)。毒副反应以骨髓抑制和周围神经炎为主,TF组的发生率显著高于OLD组(P<0.05)。结论TF方案和OLD方案治疗晚期胃癌均有较好的近期疗效,患者耐受性好,而后者的毒副反应更轻,临床应用更安全。

Objective To compare the short-term efficacy of TF （ Taxol ＋ 5-fluorouracil） and OLD { Oxaliplatin ＋5＇-DFUR ＋ LV ） in the treatment of advanced gastric carcinoma. Methods 117 gastric carcinoma patients confirmed pathalogically were randomized into TF group （ n = 51 ） and OLD group （ n = 66 ）. 28 days was taken as a chemotherapy courses. All patients received at least two courses of chemotherapy. Results The effective rate was 62.5 % in initial treatment of TF group and 59.3% in the retreatment of TF group, respectively, with overall effective rate of 60.8% and which were 54.8% and 31.4% ,respectively,with overall effective rate of 42.4% in OLD group. There was no significant difference in the effective rate of initial treatment case between the two groups （ P 〉 0.05 ）, but there was significant difference in the effective rates of retreatment group and overall effective rates between groups （ P 〈 0.05 for each ）. The median time to progression （ TIP ） and the median survival time were 8.7 months and 19 months, respectively in TF group,whereas which were 7.6 months and 17.8 month in OLD group, respectively,with no significant difference between the groups （P 〉 0.05 ）. Toxic and side effects mainly bone marrow depression and peripheral neuritis, which incidences were higher in TF group than in OLD group （P 〈 0.05 ）. Conclusion Both TF and OLD regimen have better short-term effects and well tolerated but the latter has more slighter side effects and is safer clincially.