PCF与DCF方案治疗进展期胃癌的临床观察

A clinical study of PCF and DCF regimens in the treatment of patients with advanced gastric cancer

目的探讨紫杉醇(PTX)或多西紫杉醇(TXT)与氟尿嘧啶(5-FU)/或顺铂(DDP)(简称PCF或DCF方案)治疗进展期胃癌(AGC)的疗效及安全性和生存情况。方法94例AGC患者根据不同化疗方案分为两组。PCF组50例,PTX35～50mg/m2,3h静滴,第1,8,15天;5-FU750mg/m2,持续静滴,第1～5天;DDP20mg/m2,2h静滴,第1～5天。DCF组44例,TXT35mg/m2,1h静滴,第1,8,15天;5-FU及DDP用量、用法与PCF组相同。化疗周期均为28d,两周期后评判近期疗效、安全性,持续随访远期疗效。结果PCF组总有效率(ORR)48.0%,疾病控制率(DCR)82.0%;中位生存期(MST)10.8个月,1年生存率36.0%;DCF组ORR45.5%,DCR81.8%;MST9.9个月、1年生存率34.1%;两组近远期疗效的差异无统计学意义。Ⅲ～Ⅳ级毒副反应主要为中性粒细胞减少、恶心呕吐及脱发。Ⅳ级中性粒细胞减少及贫血总发生率,DCF组显著高于PCF组(P<0.05)。结论PCF方案与DCF方案治疗AGC,疗效和生存情况相似,毒副反应均可耐受。

Objective To compare the efficacies and toxicities of paclitaxel versus docetaxel and cisplatin/fluorouracil（PCF vs. DCF regimens） in the treatment of patients with advanced gastric cancer（AGC）. Methods Ninety-four cases of AGC were divided into 2 groups according to different regimens. The patients in group PCF（50 cases） received PTX 35-50 mg/m2 iv. gtt. 3 hours, on the 1st, 8th, 15th day, 5-FU 750 mg/m2 continuous infusion, on the 1st to the 5th day, DDP 20 mg/mz iv. gtt. 2 hours,on the 1st to the 5th day every four weeks. The patients in group DCF（44 cases） received TXT 35 mg/ m2 iv. gtt. 1 hour, 5-FU and DDP were the same as PCF regimen. Results Overall response rate was 48. 0% in group PCF and 45.5% in group DCF. Disease control rate was 82.0% in group PCF and 81.8% in group DCF. The median survival time was 10. 8 months in group PCF and 9.9 in group DCF. One-year survival rate was 36. 0% in group PCF and 34. 1% in group DCF. The frequent gradeⅢ～Ⅳtoxicities were bone marrow depression, nausea/vomiting and alopecia. There was a significant difference between two groups in grade Ⅳ neutropenia and grade Ⅰ-Ⅳ anemia （P〈0.05）. Conclusion PCF and DCF regimens have similar response rate and survival for advanced gastric cancer and side effects of both regimens are tolerable.