紫杉醇联合顺铂及5-氟尿嘧啶治疗进展期胃癌的临床观察

Clinical observation of paclitaxel plus cisplatin and 5-fluorouracil in the treatment of advanced gastric cancer

目的:观察紫杉醇(PTX)联合顺铂(CDDP)及5-氟尿嘧啶(5-FU)方案(PCF方案)治疗进展期胃癌的近期疗效及不良反应。方法:选取病理检查证实的晚期胃癌患者36例,所有患者均有可评价病灶。化疗方案为:PTX 175mg/m2ivgtt d1;CDDP 20mg/m2,ivgtt d1-5;5-FU 750mg/m2,ivgtt24h d1-5。28天为1周期,所有患者至少接受2周期化疗。结果:36例患者均完成2个周期以上化疗,总有效率为61.1%,其中完全缓解(CR)3例,部分缓解(PR)19例,疾病稳定(NC)8例,疾病进展(PD)6例。生存期为5个月-24个月,中位生存期为11.5个月。主要不良反应为恶心、呕吐、腹泻和血白细胞、血红蛋白及血小板减少,其中Ⅲ度-Ⅳ度白细胞减少9人(25.0%),其余大部分反应为Ⅰ度-Ⅱ度,无化疗相关死亡病例。结论:紫杉醇联合顺铂、5-氟尿嘧啶化疗方案治疗进展期胃癌疗效较好,不良反应可耐受。

Objective：To observe the recent efficacy and toxicity of combination chemotherapy with paclitaxel plus cisplatin and 5 -fluorouracil （PCF）in the treatment of advanced gastric cancer. Methods ：Thirty -six measurable patients pathologically were enrolled into this study. The chemotherapy regimen was comprised of paclitaxel 175mg/m2, iv gtt d1 ; CDDP 20mg/m2 ,ivgtt d1-5 ;5 - Fu 750mg/m2 ,ivgtt24h d1-5- The regimen was given per 28 days. All enrolled patients received at least two cycles of treatment. Results：Thirty - six patients received at least two cycles of treatment. Response rate was 61.1% ,including complete response 3 cases, partial response 19 cases, stable disease 8 cases, and progressive disease 6 cases. Survival time was 5 months - 24 months, and with a median survival of 11.5 months. Main side effects were nausea, vomiting, diarrhea, white blood cells, hemoglobin and thrombocytopenia, grade Ill -1V leueopenia 9 cases（25.0% ）,most of the remaining reactions of grade were I - ll degrees,and no chemo- therapy related deaths. Conclusion： The combination of paclitaxel plus cisplatin and 5 - fluorouracil is an cffective chemotherapy in the treatment of advanced gastric cancer, and toxicity can be tolerated.