卡培他滨联合草酸铂和紫杉醇治疗晚期或转移性胃癌36例

Observation Study on Paclitaxel/Oxaliplatin/Capecitabine Regimen as Firstline Therapy for Patients with Advanced Gastric Cancer

目的评估卡培他滨联合苹酸铂和紫杉醇一线治疗晚期或转移性胃癌的疗效和不良反应。方法全组36例患者，口服卡培他滨1250mg·（m^2）^-1·d^-1，连用14d；静脉滴注紫彬醇90mg·（m^2）^-1·d^-1，第1天,第8天；静脉滴注草酸铂100mg·（m^2）^-1·d^-1，第1天，第8天；21d为1周期，用药2～6个周期后进行评估。结果全组34例可评价，完全缓解1例，部分缓解24例，稳定6例，进展3例，有效率为69．5％，中位疾病进展时间（TTP）为9个月（2～17个月）。中位生存时间16个月（2～38个月）。主要不良反应为胃肠反应和骨髓抑制，多为Ⅰ或Ⅱ度毒性反应，Ⅲ或Ⅳ度毒性反应主要为口腔炎、恶心呕吐、白细胞和血小板计数降低。所有患者均无化疗相关性死亡。结论卡培他滨联合草酸铂和紫杉醇一线治疗晚期胃癌患者近期疗效较好，不良反应可以耐受，值得临床推广。

Objective To evaluate the objective response rate and toxicity of paclitaxel/oxaliplatin/capecitabine regimen as first-line therapy for patients with advanced gastric cancer. Methods Thirty -six patients with advanced gastric cancer were administrated with intravenous paclitaxel 90 mg·（m^2）^ -1·d^-1 （d1 , d8 ） , intravenous oxaliplatin 100 mg·（ m^2 ）^-1·d^-1 （d1 , d8 ） , and oral capecitabine 1 250 mg·（ m^2 ）^-1 · d^ -1 （ d1 - 14） in a 21 -day cycle of therapy for 2 - 6 cycles. Results Thirty-four patients were assessable for efficacy and toxicity. One patient achieved a complete response and 24 patients had partial responses, with an overall response rate of 69.5 %. The median TTP for all was 9 months（ range 2-17 months）. The median overall survival was 16 months （range 2-38 months）. The most common adverse effects were myelosuppression and gastrointestinal response. There was no chemotherapy-related death. Conclusion The combination of capecitabine and oxaliplatin/paclitaxel is effective and well tolerated as first-line therapy for patients with advanced gastric cancer.