不同化疗方案治疗晚期胃癌的近期疗效观察

Effects of different Chemotherapy Regimens for Advanced Gastric Carcinoma

目的:观察5-氟尿嘧啶/四氢叶酸钙分别联合顺铂、草酸铂和紫杉醇3组化疗方案治疗晚期胃癌的近期疗效和毒副作用。方法:将经病理证实为晚期胃癌的患者63例分别给予顺铂(21例)、草酸铂(23例)、紫杉醇(19例)为主分别联合5-氟尿嘧啶/四氢叶酸钙方案化疗,21 d重复,接受两个化疗周期后进行疗效和毒性评价。结果:顺铂组、草酸铂组和紫杉醇组化疗近期有效率分别为23.8%、34.8%和47.4%。三组的化疗疗效比较差异无统计学意义(P>0.05)。毒副反应紫杉醇组和草酸铂组以骨髓抑制,周围神经炎以及脱发为主,但两组之间比较差异无统计学意义(P>0.05);周围神经炎和脱发与顺铂组比较差异有统计学意义(P<0.05)。结论:紫杉醇组和草酸铂组联合方案治疗晚期胃癌近期疗效与顺铂组比较无显著差异,而毒副反应比顺铂组联合方案严重。

Objective：To compare the short-term efficacy of paclitaxel（taxol＋5-fluorouracil＋CF）、 oxaliplatin（oxaliplatin＋5-fluorouracil＋CF）rand cisplatin（DDP＋5-fluorouracil＋CF）in the treatment of advanced gastric carcinoma.Methods：A total of 63 advanced gastric carcinoma patients confirmed phthologically were randomized to paclitaxel group（n=19）,oxaliplatin group（n=23）and cisplatin group（n=21）.21 days was one chemotherapy course.All patients received at least two courses of chemotherapy.Results：The overall effective rate of paclitaxel group was 47.4%,which was 34.8%in oxaliplatin group and 23.8%in cisplatin group,There was no significant difference in the overall effective rate between these 3 groups（P〉0.05）.Toxic and side effects mainly were bone marrow depression,peripheral neuritis and alopecia,which incidences were higher in paclilaxel group and oxaliplatin group thsn in cisplatin group（P〈0.05）,but there was no significant difference between paclitaxel group and oixaliplatin group（P〉0.05）.Conclusion：Both the paclitaxel group and oxaliplatin group regimen have no better short-term effects than cisplatin group but the toxic and side effects of peripheral neuritis and alopecia are more severe.