紫杉醇联合羟基喜树碱和氟尿嘧啶治疗晚期胃癌

Paclitaxei in Combination with Hydroxycamptothecin and Fluorouracil for Advanced Gastric Cancer

目的观察紫彬醇联合羟基喜树碱和氟尿嘧啶治疗晚期胃癌的近期疗效,毒性反应。方法23例患者,均经病理或细胞学证实并有远处转移的晚期胃癌患者。采用紫杉醇135mg/m^2～175mg/m^2 ivgtt 3h,d_1,羟基喜树碱10mg ivgtt,d_1～d_5,醛氢叶酸200mg/m^2 ivgtt 2h,d_1～d_5,氟尿嘧啶375mg/m^2 civ 24h,d_1～d_5.3～4周为1周期。按WHO标准评价疗效和毒性。结果全组23例均可评价,获得CR1例(4.3%),PR 10例(43.5%),NC 9例(39.1%),PD 3例(13.0%),总有效率(CR+PR)11例(47.8%)。主要毒性反应为骨髓抑制、胃肠道反应及脱发。结论紫杉醇联合羟基喜树碱和氟尿嘧啶治疗晚期胃癌近期疗效较好,不良反应可以耐受,值得进一步研究。

Objective To evaluate the efficacy and toxicity of Paclitaxel in combination with Hydroxycamptothecin and Fluorouracil on advanced gastric cancer. Methods Twenty- three patients of advanced gastric cancer who were confirmed by pathology or cytology with focus of distant metastasis were treated by Paclltaxel 135mg/m^2 - 175mg/m^2 ivgtt 3h, d1 , Hydroxycamptothccin 10mg ivgtt, d1- d5, Leucovorin 200mg/m^2 ivgtt 2h, d1 - d5 , Fluorouracil 375mg/m^2 civ 24h, d1 - d5 , with 3 -4 weeks being one cycle. The efficacy and toxicity were evaluated by the WHO Standard. Results Twenty -three patients can be included for response rate, among which 1 case showed CR, 10 cases showed PR, 9 showed NC, 3 showed PD and 11 （ CR ＋ PR） showed the total response rate of 47. 8%. The main toxicity effect was myelosuppression, reaction of gastrointestinal tract and Alopecia. Conclusions The rcgimen of Paclitaxel in combination with Hydroxycamptothecin and Fluorouracil for patients with advanced gastric cancer produced high response rate and its adverse cffect is well tolerable.