周剂量紫杉醇联合奥沙利铂二线治疗晚期胃癌23例

Therapy of paclitaxel plus oxaliplatin as a second-line chemotherapy for patients with advanced gastric cancer: an analysis of 23 cases

目的:观察周剂量紫杉醇联合奥沙利铂二线治疗晚期胃癌的疗效和不良反应.方法:收集2006-07-01/2008-01-31我科以周剂量紫杉醇联合奥沙利铂治疗一线化疗失败的晚期胃癌患者23例,给予紫杉醇70mg/m2,静脉滴注1h,第1、8、15天;奥沙利铂100mg/m2,静脉滴注2h,第2天,每28天为1个周期.每例患者治疗至少2个周期,2个周期化疗完成后4wk评价疗效.结果:在可评价疗效的23例患者中,完全缓解(CR)0例,部分缓解(PR)8例(34.8%),疾病稳定(SD)8例(34.8%),疾病进展(PD)7例(30.4%);总有效率(CR+PR)34.8%,95%CI为16%-57%;临床获益者(CR+PR+SD)共16例(69.6%),95%CI为47%-87%.平均肿瘤进展时间(TTP)为3.93±1.47mo.不良反应主要为脱发、骨髓抑制和外周神经毒性.结论:周剂量紫杉醇联合奥沙利铂二线治疗晚期胃癌疗效好,不良反应可耐受.

AIM： To evaluate the efficacy and adverse effects of paclitaxel combined with oxaliplatin as a second-line chemotherapy for patients with advanced gastric cancer. METHODS： Twenty-three cases with advanced gastric cancer who failed first-line therapy received paclitaxel combined with oxaliplatin chemotherapy from July first, 2006 to January 31, 2008. Paclitaxel （70 mg/m^2） was administered by intravenous drip for 1 h on the first, eighth, fifteenth day; oxaliplatin 100 mg/m^2 was administered by intravenous drip for 2 h on the second day. Each treatment cycle included 28 days. Each patient was treated for more than two circles and evaluated four weeks later. RESULTS： Of the 23 patients, none showed complete remission （CR）, 8 （34.8%） showed partial remission （PR）, 8 （34.8%） showed stable disease （SD） and 7 （30.4%） showed progressive disease （PD）. The overall response rate was 34.8% with a 95%CI （range： 16%-57%）; and 16 patients （69.6%） benefited （CR±PR±SD） from the clinical therapy with a 95%CI （range： 47%-87%）. The mean time to tumor progression （TTP） was 3.93 ± 1.47 months. The main side effects were alopecia, myelosuppression and peripheral neuropathy. CONCLUSION： The regimen of paclitaxel plus oxaliplatin has a definite effect with acceptable toxicity for patients with advanced gastric cancer.