紫杉醇联合氟脲嘧啶和亚叶酸钙方案治疗晚期胃癌的临床观察

Clinical Study of Paclitaxel Combined with 5-Fu/CF in the Treatment of Patients with Advanced Gastric Cancer

目的观察含紫杉醇联合氟脲嘧啶/亚叶酸钙方案治疗晚期胃癌的近期疗效及毒副反应。方法晚期胃癌43例患者均给予紫杉醇(PTX)135mg/m2,静滴3h,第一天给药;亚叶酸钙(CF)200mg/m2静脉滴注2h,给予氟脲嘧啶(5-Fu)500mg/m2静脉推注,后续5-Fu3000mg/m2,持续静脉输注泵泵注48h,21天为1周期,至少应用3周期后按WHO标准评价疗效和毒副反应。结果全组43例可评价疗效41例,完全缓解(CR)4例,部分缓解(PR)21例,稳定(SD)12例,进展(PD)4例,近期客观有效率60.98%,中位TTP为8.3个月。可评价毒性患者41例,主要毒副反应为骨髓抑制、胃肠道反应和脱发。结论PTX联合5-Fu/CF治疗晚期胃癌有较好的疗效,毒性反应轻可耐受,值得在临床上推广。

Objective To evaluate the efficacy and adverse effects of paclitaxel combined with 5-fluorouracil calcium flinate in the treatment of patients with advanced gastric cancer. Methods 43 cases with adv-anced gastric cancer were enrolled. PTX 135mg/m^2 iv 3hr d1 ,CF 200mg/ m^2 iv infusion for 2h fol lowed by 5 Fu 500mg/m^2 iv bolus and 5 Fu 3000/m^2 iv infusion through the vein bump for 48h repeated every 3 weeks. Tumor assessment was done after 3 cycles. Results 43 patients entered this study, 41 cases were valuable for efficacy： CR 4 cases, PR 21 cases, SD 12cases, PD 4 cases. The overall response rates （ORR） and median TFP was 60. 98% and 8.3 months respectively. The main toxici-ties were myelosuppression,nausea/vomiting and alopecia. Conclusion This regimen of paclitaxel combined with 5- fluorouracil/calcium flinate was more effective for the treatment of advanced gastric cancer, the toxicity was mild and tolerable, which is worthy further clinical study.