紫杉醇联合希罗达治疗晚期胃癌31例

Treatment of patients with advanced gastric cancer with paclitaxel combined with Xeloda:an analysis of 31 cases

目的:观察紫杉醇联合希罗达治疗31例晚期胃癌患者的疗效和副作用.方法:紫杉醇175 mg/m^2,静脉滴注3 h,第1天;希罗达1000 mg/m^2,po,2次/d,第1-14天,每21或28天为1个周期.每例患者治疗至少2个周期,2个周期化疗4 wk后评价疗效.结果:在可评价疗效的31例患者中,完全缓解(CR)1例(3.2%),部分缓解(PR)15例(48.4%),稳定(SD)10例(32.3%),进展(PD)5例(16.1%),总有效率(CR+PR)51.6%,95%可信区间为33%-70%;临床获益者(CR+PR+SD)共26例(83.9%),95%可信区间为66%-94%;平均肿瘤进展时间(TTP)为5.32±1.85 mo;平均生存期(MST)为11.40±1.68 mo.不良反应主要为恶心呕吐、骨髓抑制、腹泻、手足综合征及脱发.结论:紫杉醇联合希罗达治疗晚期胃癌疗效好,副作用小,患者耐受性好.

Abstract AIM： To evaluate the efficacy and adverse effects of a regimen of paclitaxel and Xeloda in the treatment of patients with advanced gastric cancer. METHOOS： Paclitaxel （175 mg/m^2） was administered by intravenous drip for 3 h in the first day of the experiment; Xeloda （1000 mg/m^2） was administered po, twice between the first day and the fourth day, and then every 21 or 28 days. Each patient was treated for more than two circles and evaluated four weeks later. RESULTS： Among the 31 evaluable patients, 1 （3.2%） showed complete remission （CR）, 15 （48.4%） showed partial remission （PR）, 10 （32.3%） showed stable disease （SD） and 5 （16.1%） showed disease progression （PD）. The overall response rate was 51.6% with a 95% confidence interval （CI） （range： 33%-70%）; and 26 （83.9%） of the patients benefited （CR ＋ PR ＋ SD） from the clinical therapy with a 95% CI （range： 66%-90%）. The mean time to tumor progression （TTP） was 5.32 ± 1.85 months, and the mean survival time （MST） was 11.40 ± 1.68 months. The main side effects were nausea and vomiting, myelosuppression, diarrhea, hand-foot syndrome and alopecia. CONCLUSION： A regimen of paclitaxel and Xeloda has a definite effect with acceptable toxicity in the treatment of patients with advanced gastric cancer.