多西紫杉醇联合草酸铂和5-氟尿嘧啶治疗晚期耐药性胃癌

The clinical investigation of the docetaxel, oxliplatin and 5-FU/CF combination regimen for advanced gastric cancer

目的观察多西紫杉醇(DOC)联合草酸铂(L-OHP)和5-氟尿嘧啶(5-FU)方案治疗进展期胃癌一线方案失败的疗效及毒副作用。方法采用DOC75mg/m2,第1天;L-OHP100～130mg/m2;醛氢叶酸0.2/m2第1、2天;5-FU500mg第1、2天;5-FU2.0/m2微量泵持续静脉滴注48h,21d为1个周期,连用3个周期进行评价。共治疗37例进展期胃癌患者。结果37例患者均可评价,获得CR0例,PR11例(29.73%),SD13例(35.14%);PD13例(35.14%):临床受益率(CBR)为78.38%%。与药物相关的不良反应依次为:Ⅱ～Ⅲ度白细胞减少26例(70.27%);Ⅱ～Ⅲ度血小板减少14例(37.84%);Ⅱ～Ⅲ度恶心、呕吐21例(56.76%);Ⅱ～Ⅲ度腹泻19例(51.35%);Ⅰ～Ⅱ度神经毒性反应22例(59.46%)。结论DOC、L-OHP和5-FU联合方案治疗进展期耐药性胃癌患者有效,毒副反应少,患者临床受益。

Objective To observe the efficacy and toxicity of the docetaxel,oxliplatin,and 5-FU/CF combination regimen in treating advanced gastric cancer.Methods A total of 37 patients were enrolled between February 2003 and January 2006, and were treated with 1-hr infusion of docetaxel 75mg/m2 on day 1, and with 3-hr infusion of oxliplatin 100-130mg/m2 on day 1,and 2-hr infusions of CF 200mg/m2 followed by 48 hr infusion 5-FU 2.0g/m2 for 2 consecutive days every 3 weeks until progression or unacceptable toxicity for 3 cycles.Then the response rate was evaluated.Results All the patients were evaluable with an overall response rate of 48.65%（18/37）, including 2CR and 16PR, and an clinical benefit rate（CBR）of 81.08%（30/37）.The main adverse reations were Ⅱ-Ⅲ° neutropenia（70.27%）;Ⅱ-Ⅲ° thrombocytopenia（37.84%）;Ⅱ-Ⅲ° nausea and vomiting（56.76%）;Ⅱ-Ⅲ° diarrhea（51.35%）;Ⅰ-Ⅱ neuropathy（59.46%）.Conclusion The docetaxel, oxliplatin,and 5-FU/CF combination regimen is effective and tolerable with acceptable toxicity, and can provide a clinical benefit in advanced gastric cancer.