紫杉醇或草酸铂联合氟脲嘧啶/亚叶酸治疗晚期胃癌的对比研究

Comparison between the Effects of Paclitaxel and Oxaliplatin Combined with 5-Fluorouracil/Folinic Acid in the Treatment of Advanced Gastric Cancer

目的:观察并比较紫杉醇联合氟脲嘧啶/亚叶酸(5-FU/CF)与草酸铂联合5-FU/CF治疗晚期胃癌的疗效及毒副反应。方法:随机将晚期胃癌患者分为两组:紫杉醇联合5-FU/CF组(A组)27例,草酸铂联合5-FU/CF(B组)29例。每例患者至少完成2周期以上的化疗。结果:A组有效率(CR+PR)为59.26%,中位缓解期5.8个月,中位生存期11.6个月。B组有效率(CR+PR)为55.17%,中位缓解期6.2个月,中位生存期10.8个月。两组的主要毒副反应为骨髓抑制、神经毒性和消化道反应。两者相比A组的骨髓抑制、脱发较重,B组轻度腹泻的发生率稍高。结论:紫杉醇联合5-FU/CF与草酸铂联合5-FU/CF两方案治疗晚期胃癌疗效相当,毒副反应均可耐受。

Objective： To observe and compare the therapeutic efficacy and adverse side effects of paclitaxel and oxaliplatin （L-OHP） combined with 5-fluorouracil/leucovorin （5-FU/CF） in the treatment of patients with advanced gastric cancer （AGC）. Methods： A total of 56 patients with AGC were randomized into two groups. Two or more cycles of chemotherapy were completed. Group A consisted of 27 patients who received paclitaxel plus 5-FU/CF and group B consisted of 29 patients who received oxaliplatin plus 5-FU/CF. Results： In group A and B, the response rate （CR ＋PR） was 59.26% and 55.17%, the median duration of the therapeutic effects was 5.8 and 6.2 months, and the median survival of patients was 11.6 and 10.8 months, respectively. The most common side effects in both groups were myelosuppression, mild neuro-sensory toxicity and sensitivity of the gastrointestinal tract. Compared with patients in group A, patients in group B experienced milder myelosuppression and more serious diarrhea. Conclusion： The effects of paclitaxel or L-OHP combined with 5-FU/CF are comparable. The adverse side effects are mild and patients tolerate the chemotherapy well.