紫杉醇联合低剂量5-FU持续静脉滴入治疗晚期胃癌临床观察

Clinical study of paclitaxel combined with 5-fluorouracil in treatment of advanced gastric carcinoma

目的:观察紫杉醇联合5FU(TFciv方案)治疗晚期胃癌的有效性及安全性,同期对照HELF方案。方法:83例晚期胃癌患者,分别采用两种化疗方案治疗。TFciv方案:紫杉醇60mg/m2,静脉滴入,d1、d8和d15;5FU250mg/m2,静脉微量泵24h持续滴入,d1～d14,21d为1个周期。HELF方案:羟基喜树碱8mg/m2,静脉滴入,d1～d5;依托泊苷60mg/m2,静脉滴入,d1～d5;CF100mg/m2,静脉滴入,d1～d5;5FU600mg/m2,静脉滴入,d1～d5。两种方案均至少治疗2个周期。结果:TF组34例,获得CR1例,PR18例,总有效率55.8%;HELF组49例,PR24例,总有效率49.0%;两组差异无统计学意义,P=0.536。TF组有效者26例(79.4%);HELF组有效者28例(53.1%),治疗组明显高于对照组,P=0.014。TF方案在骨髓抑制、脱发和肌肉关节痛等方面较HELF方案明显,而胃肠道反应、肝肾功能异常及黏膜炎等方面两组差异无统计学意义。结论:紫杉醇联合5FU组成TFciv方案治疗晚期胃癌疗效较好,毒副反应可以耐受。

OBJECTIVE：To observe the therapeutic effects and toxicity of a regimen, which consists of PTX combined with 5-FU, for treatment of advanced gastric carcinoma. HELH regimen was contrasted at the same time. METHODS：A total of 83 patients with advanced gastric carcinoma were divided into two groups. Thirty-four cases received TF civ and 49 cases received HELF regimen. TF group with PTX 60 mg/m^2 infusion on the first, 8th and 15th day; 5-FU 250 mg/m^2 using an ambulatory pump continuous infusion from the first to 14th day, and one cycle consisted of 21 days. HELF group with HPT 8 mg/m^2 ; Vp-16 60 mg/m^2 ; CF 100 mg/m^2 and 5-FU 600 mg/m^2 infusion from the first to 5th day. All patients received over two cycles of the two chemotherapy regimens respectively. RESULITS： In the TF group, gross efficiency rate was 55. 8% with 1 case of CR and 18 cases of PR. the HELF group at the same time, gross efficiency rate was 49. 0% with 24 cases of PR （P=0. 536）. As to CBR, TF group＇s efficiency rate was 79. 4% with 26 cases,being better than HELF group＇s 53. 1% with 28 cases （P=0. 014）. Major side reactions of gastrointestinal hepatorenal, dysfunction tract reaction and mucsitis in the two groups were nearly the same, whereas, side reactions of marrow suppression, alopecia, musculoskeletal pain in TF group were severer than these in HELF group. CONCLUSIONS： TF civ regimen is effective in the treatment of advanced gastric carcinoma with tolerable toxities.