紫杉醇脂质体或紫杉醇联合5-氟尿嘧啶一线治疗晚期胃癌的临床疗效分析

Comparison of the therapeutic effects of paclitaxel liposome-5-Fu versus paclitaxel-5-Fu on 67 patients with advanced gastric cancer

目的比较紫杉醇脂质体联合5-氟尿嘧啶（5-Fu）与紫杉醇联合5-Fu-线治疗晚期胃癌的近期疗效、不良反应及预后。方法经病理或细胞学证实的67例晚期胃癌患者，31例接受紫杉醇脂质体联合5-Fu方案化疗（力扑素组），34例接受紫杉醇联合5-Fu方案化疗（紫杉醇组）。按照世界卫生组织（WHO）标准评价近期疗效，按照WHO关于化疗药物不良反应的评价标准评价不良反应。结果力扑素组和紫杉醇组的客观有效率分别为54．8％和44．1％（P=0．388），中位疾病进展时间分别为5．10和5．20个月（P=0．266），中位生存时间分别为10．07和8．97个月（P=0．186）。力扑素组和紫杉醇组的主要不良反应为血液学毒性及恶心呕吐，Ⅲ～Ⅳ度恶心呕吐的发生率为16．1％和50．0％（P=0．038），肌肉关节痛的发生率为9．7％和29．4％（P=0．047）。结论紫杉醇脂质体联合5-Fu使用方便，与紫杉醇联合5-Fu-线治疗晚期胃癌疗效相当，但Ⅲ～Ⅳ度不良反应发生率较低。

Objective To explore the efficacy, time to disease progression （TTP）, overall survival （OS） and toxicity of paelitaxel liposome versus paclitaxel combined with 5-fluorouracil （5-Fu） for patients with advanced gastric cancer. Methods The therapeutic efficacy of chemotherapy with either of the two regimens for 67 cases of nai＇ve advanced gastric cancer was analyzed. Among them, 31 patients in the paclitaxel liposome-5-Fu group received paclitaxel liposome 175 mg/m2 dl, CF 200 mg/m2 dl, 5-Fu 2.6 g/m2 civ. 46 hours, 21 days as one cycle, and 34 patients in the paclitaxel-5-Fu group received paclitaxel 175 mg/m2 dl, CF 200 mg/m2 dl, 5-Fu 2.6 g/m2 civ. 46 hours, 21 days as one cycle. Results The objective response rate was 54.8% in the paelitaxel liposome group and 44.1% in the paclitaxel group （P =0. 388 ）. The median time to progression was 5. 10 months vs. 5.20 months （ P = 0. 266 ） and the median survival time was 10.07 months vs. 8.97 months （P = 0. 186）. The most frequent side-effects were nausea, vomit and hematological toxicities. The rates of grade Ⅲ～Ⅳ nausea and vomit were 16.1% and 50.0% （P = 0.038）, muscle and joint pain were 9.7% and 29.4% （P = 0. 047）. Conclusion Both regimens are effective in the treatment of advanced gastric cancer. However, less adverse effects occur in the paclitaxel Iiposome group.