紫杉醇联合顺铂及氟尿嘧啶方案治疗晚期转移性胃癌的临床观察

Paclitaxel combined with cisplatin and fluorouracil regiment in treatment of advanced and metastatic gastric cancer

目的：研究紫杉醇（PTX）对比多西他赛（TXT）联合顺铂（DDP）、氟尿嘧啶（5-FU）一线治疗晚期转移性胃癌的近期疗效和不良反应。方法：将48例晚期转移性胃癌患者分为治疗组和对照组。治疗组（n=23）采用PCF（PTX 160 mg/m2,静脉滴入,d1;DDP 60 mg/m2,静脉滴入,d1;5-FU2.5 g/m2,用便携微量泵静脉持续滴入48 h）方案;对照组（n=25）采用DCF（TXT 70 mg/m2,静脉滴入,d1;DDP60 mg/m2,静脉滴入,d1;5-FU2.5 g/m2,用便携微量泵静脉持续滴入48 h）方案化疗。至少完成2个周期化疗后评价两组有效率（RR）、疾病控制率（DCR）及不良反应。结果：两组均可评价疗效。治疗组RR为52.2%,DCR为82.6%;对照组RR为48.0%,DCR为80.0%。两组比较差异均无统计学意义,P值均〉0.05。治疗组与对照组主要不良反应有粒细胞减少、脱发、恶心呕吐和过敏反应等。两组不良反应比较,3~4级粒细胞减少差异有统计学意义,P〈0.05。结论：PCF方案治疗晚期转移性胃癌疗效与DCF方案相似,不良反应PCF方案优于DCF方案,值得进一步研究。

OBJECTIVE：To investigate the clinical efficacy and adverse events of Paclitaxel（PTX） versus docetaxel（TXT） combined with cisplatin and fluorouracil on advanced gastric carcinoma as first line therapy.METHODS：Forty-eight patients with advanced and metastatic gastric cancer were enrolled in this study and divided into two groups： the research group and the control group with 23 and 25 patients respectively.Patients in the PCF regimen group（research group） were given PTX 160 mg/m2,d1,iv.drip;DDP 60 mg/m2,d1,iv.drip;5-FU 2.5 g/m2,48 h,iv.drip.Patients in the DCF regimen group were given TXT 70 mg/m2,d1,iv.drip;DDP 60 mg/m2,d1,iv.drip;5-FU 2.5 g/m2,48 h,iv.drip.After at least two cycles,the response rate（RR）,disease control rate（DCR）,and adverse events were evaluated.RESULTS： The clinical efficacy could be evaluated in all patients.The RR was 52.2% in the research group and 48.0% in the control group.The DCR was 82.6% in the research group and 80.0% in the control group.Two groups did not reach statistical significance between the RR and DCR（P0.05）.The major side effects included bone marrow suppression,alopecia,nausea,vomiting and allergic reactions.There was significant difference in Ⅲ-Ⅳ bone marrow suppression between the two groups（P0.05）.CONCLUSIONS： The clinical efficacies are similar in two groups,but the adverse events of PCF regimen are less than that of DCF regimen for advanced gastric carcinoma.It needs more samples and further research.