多西他赛联合顺铂和氟尿嘧啶治疗晚期胃癌疗效观察

Efficacy of combination chemotherapy with docetaxel plus cisplatin and 5-fluorouracil in treatment of patients with advanced gastric cancer

目的 观察多西他赛联合顺铂、氟尿嘧啶（DCF方案）治疗晚期胃癌的疗效和不良反应。方法 采用DCF方案治疗33例晚期胃癌患者。多西他赛75 mg/m^2,d1;顺铂75 mg/m^2,d1;氟尿嘧啶750 mg/m^2,持续静脉滴注,d1～5,3周1个周期,至少2个周期。结果 33例晚期胃癌中,完全缓解（CR）0例,部分缓解（PR）18例（54.5%）,稳定（SD）8例（24.2%）,进展（PD）7例（21.2%）。中位肿瘤进展时间为6.1个月（3.5～11.5个月）,中位总生存期为11.2个月（6.0～14.5个月）。最常见的不良反应为骨髓抑制、消化道反应及可逆性体液潴留,不良反应多为Ⅰ～Ⅱ度,无Ⅳ度不良反应发生。骨髓抑制以白细胞减少为特点,血小板减少及贫血较轻。消化道反应主要表现为恶心呕吐、腹泻、便秘,无Ⅳ度腹泻发生。无治疗相关性死亡。结论 DCF方案是治疗晚期胃癌安全有效的化疗方案。

Objective To assess the efficacy and safety of docetaxel plus cisplatin and 5-fluorouracil in treatment of patients with advanced gastric cancinoma. Methods Thirty-three patients with recurrent or metastatic gastric adenocarcinoma were enrolled and received docetaxel （75 mg/m^2 , dl ） plus cisplatin （75 mg/m^2 ,dl ）followed by 5-fluorouracil （750 mg/m^2, continous iv gtt dl-5 ）. The treatment was repeated every 3 weeks. Results All the thirty-three patients enrolled were evaluated for response and toxicity. The overall response rate was 54.5% with complete and partial response rates of 0 and 54.5% ,respectively. The median overall survival time was 11.2 months, and the median time to tumor progress was 6. 1 months. The regimen was given without any grade-Ⅳ toxicity, but grade-Ⅲ diarrhea in 2 patients （6.0%） , grade-Ⅲ leukopenia in 3 patients （9.0%）, and grade-Ⅲ vomiting in 8 patients （24.0%）. Conclusion Combination regimen of docetaxel plus cisplatin and 5-fluorouracil is well tolerable and shows notable activity as first-line treament in metastatic carcinoma of the stomach.