局部晚期胃癌的新辅助化疗的临床研究

The Study of Neoadjuvant Chemotherapy in Treatment of Locally Advanced Gastric Cancer

目的 探讨以多西紫杉醇为主联合替加氟及表柔比星的新辅助化疗方案治疗局部晚期胃癌的疗效及毒副作用。方法 自2002年2月——2006年3月，有43例局部晚期胃癌病人入组本次临床研究。入组病人接受的新辅助化疗方案：替加氟500mg／m^3／亚叶酸钙100-200mg，第1～3天,表柔比星50mg／m^，第2天；多西紫杉醇45mg／m^2，第2天，每周为一个周期，共3个周期。观察新辅助化疗后肿瘤原发病灶的缓解情况．并观察毒副反应。结果 所有接受新辅助化疗后的病人临床有效率（CR＋PR）为53，5％（23／43），其中完全缓解（CR）占9，3％（4／43），部分缓解（PR）占44．2％（19／43），痰病稳定（SD）占25．6％（11／43），疾病进展（pD）占20．9％（9／43）。手术切除率90．7％（39／43），术后病理水平缓解率11．6％（5／43），其中3例达到完全缓解。毒副反应主要为白细胞减少症、腹泻、恶心、呕吐、脱发。结论 以多西紫杉醇为主联合替加氟厦表柔比星的新辅助化疗方案在局部晚期胃癌的治疗中近期疗效显著，耐受性良好。

Objective To evaluate the efficacy and toxicity of docetaxel and fluorouracil plus Epirublcin as the neoadjvant chemotherapy in the treatment of locally advanced gastric cancer. Methods From February 2002 to March 2006,43 cases of locally advanced gastric cancer patients were treated with DEF regimen. It contained docetaxel（D） ,45 mg/m^2 （days 2）,fluorouracil（F）,500mg/m2 （days 1to 3） and Epirublcin （E）,50 mg/m^2 （days 2） was administered every one week for three cycles. The response in the primary tumor and the chemotherapy toxicity were observed in each patient. Results The response in the primary tumor ： clinical efficacy rate was 53. 5% （9.3% CR and 44. 2% PR,25. 6% SD and 20.9%PD）. Radical operation rate was 90.7 %, Pathological response rate was 11.6 %, completc pathological response was found in three cases. The most common toxlcities were leukocytopenia, nausea/vomiting and alopcia. Leucopenia of grade 1 - 3 was presented in 33 cases of the patients but there was no chemotherapy related toxic death. Conclusions The combination of fluorouracil plus Epirubicin and docetaxel is an effective and well--tolerated regimen as neoadjvant chemotherapy for locally advanced gastric cancer.