多西他赛联合顺铂和氟尿嘧啶治疗进展期胃癌的疗效评价

Effect of docetaxel combined with cisplatin and 5-fluorouracil for advanced gastric cancer

目的 探讨多西他赛联合顺铂和氟尿嘧啶治疗进展期胃癌的疗效和毒副反应.方法 35例经病理确诊的进展期胃癌应用多西他赛、顺铂（DDP）、氟尿嘧啶（5-Fu）化疗,其中多西他赛70 mg/m^2静滴4 h,第1天;DDP 20 mg/m^2静滴d 1～d 5;5-Fu 750 mg/m^2静滴6 h,d 1～d 5,每3～4周重复.化疗有效者至少4～6个疗程或一直治疗至疾病进展（PD）为止.结果 有32例（91.4%）患者可以评价客观疗效,其中完全缓解（CR）0,部分缓解（PR）15例,稳定（SD）7例,进展（PD）10例.总缓解（CR＋PR）率46.9%（15/32）,CR率为0,SD率为21.9%（7/32）.骨髓抑制主要表现为WBC下降,发生率为40.0%,其中Ⅲ～Ⅳ度者占13.6%,有1例发生发热性粒细胞减少,经积极处理好转,未见严重的全身感染和治疗相关死亡.结论 多西他赛联合顺铂和氟尿嘧啶方案是治疗进展期胃癌的有效方案,毒副反应可耐受,临床使用安全.

Objective To evaluate the efficacy and toxicity of docetaxel combined with Cisplatin（DDP） and 5-fluorouracil（5-Fu） in the treatment of advanced gastric cancer. Methods 35 patients with advanced gastric cancer,which were confirmed by pathological diagnosis,were treated with docetaxel ＋ DDP ＋5-Fu regimen：docetaxel 70 mg/m^2 iv infusion for 4 hours on day 1, DDP 20 mg/m^2 iv infusion on day 1 to 5,5-Fu 750 mg/m^2 iv infusion for 6 hours on day 1 to 5 every 3 ～ 4weeks. Patients responsing to the chemotherapy finished at least 4 ～ 6 cycles or proceeded the therapy until progression of the disease （PD）. Results 32 cases （91.4% ） were available for response evaluation with CR0;PR 15;SD7;PD 10. The rate of total remission（ CR ＋ PR） was 46.9% （15/32） ,and rates of CR and SD were 0 and 21.9% respectively. Leucopenia was seen in 40% patients,in which 13.6% cases were in grade III -IV. One patient had fever with neutropenia and improved after active treatment. There was no systemic infection or therapy-related death in all patients. Conclusion Docetaxel ＋ DDP ＋5-Fu regimen has an assured response for advanced gastric cancer with tolerable toxicity and could be an effective candidate in clinical treatment.