紫杉醇联合顺铂、氟尿嘧啶治疗晚期胃癌35例临床分析

Paclitaxel Plus Cisplatin and Fluorouracil in Advanced Gastric Cancer:Thirty-five Cases Report

目的研究紫杉醇联合顺铂、氟尿嘧啶方案(PCF)治疗晚期胃癌的疗效及安全性。方法回顾性分析2002年11月～2006年11月北京协和医院肿瘤内科收治的使用PCF方案化疗的所有晚期胃癌患者,共35例。化疗方案:紫杉醇(PTX)150mg/m2,静滴3h,第1天给药;顺铂(DDP)12mg/m2,静脉滴注,第1～5天;氟尿嘧啶(5-Fu)3000mg/m2,持续静脉输注120h;每21天为1周期。分别化疗2～6周期后按RECIST标准评价疗效,按NCI-CTC标准评价毒副反应。结果15例局部晚期胃癌患者,术后PCF辅助化疗,中位无进展生存时间(PFS)11.0月,中位总生存时间(OS)18.6月。20例远处转移胃癌患者,15例可评估,完全缓解0例(0),部分缓解3例(20%),疾病稳定9例(60%),疾病进展3例(20%)。中位疾病进展时间(TTP)为7.0月,中位总生存时间(OS)9.0月。3/4度不良反应主要是恶心(18.1%),中性粒细胞减少(9.4%)和乏力(7.9%)。9.5%的患者出现中性粒细胞减少性发热。结论PCF方案的不良反应可以耐受,疗效值得进一步研究。

Objective To evaluate the toxicity and efficacy of combination chemotherapy with paclitaxel plus cisplatin and fluorouracil （PCF）in advanced gastric cancer. Methods Between 2002 and 2006, thir- ty-five advanced gastric cancer patients who received PCF regimen were analyzed retrospectively. The combination chemotherapy included paclitaxel 150 mg/m^2 as 3 hours infusion on day 1, cisplatin 12 mg/ m^2/d on days 1 to 5 and 5-Fu 3 g/m^2 over 120h infusion. The therapy repeated every 3 weeks. Results Fifteen local advanced gastric cancer patients received PCF regimen after operations. Median time to progression and overall survival time were 11.0 months and 18. 6 months, respectively. Twenty patients with metastatic gastric cancer received PCF regimen as salvage therapy. Fifteen patients were assessable. Complete response 0 （0）, partial response 3 （ 20 % ）, stable disease 9 （60 % ） and progressive disease 3 （ 20 % ）. Median time to progression and overall survival time were 7. 0 months and 9. 0 months, respectively. Frequent grade 3/4 toxicity for PCF were：nausea 18. 1%,neutropenia 9. 4% and fatigue 7. 9%. Febrile neutropenia occurred 9. 5 %. Conclusion The toxicity of PCF regimen was acceptable and the efficacy needed further evaluation.