多西紫杉醇、奥沙利铂联合5-氟尿嘧啶与mFOLFOX6方案治疗进展期胃癌疗效分析

Docetaxel and Oxaliplatin Plus Fluorouracil Compared With Fluorouracil/Leucovorin Plus Oxaliplatin in Patients with Advanced Gastric Cancer

目的比较多西紫杉醇(Doc)、奥沙利铂(L-OHP)联合5-氟尿嘧啶(5-FU)与奥沙利铂/亚叶酸钙(LV)联合5-氟尿嘧啶(mFOLFOX6)方案治疗进展期胃癌的近期疗效和不良反应。方法回顾性分析60例进展期胃癌患者,其中DOF组38例接受Doc、L-OHP联合5-FU方案,mFOLFOX6组22例接受L-OHP联合5-FU方案,3周为1周期。结果入组的60例均可评价疗效,DOF组有效率34%,中位无进展生存期(PFS)3.5个月,mFOLFOX6组有效率27%,中位PFS 4.0个月。不良反应比较,Ⅰ/Ⅱ级血液毒性及脱发发生率以DOF组显著(P<0.05),其余不良反应发生率差异无统计学意义。Cox多因素分析结果提示临床病理分型、Karnofsky评分是影响无进展生存时间的独立预后因素。结论 DOF方案与mFOLFOX6方案治疗晚期胃癌均显示较好疗效,不良反应可耐受。两者相比,DOF组在缓解率方面略优于mFOLFOX6组。临床病理分型、Karnofsky评分是影响无进展生存率的独立预后因素。

Objective To compare the immediate effects and toxicities in patients with advanced gastric cancer treated with Docetaxel and oxaliplatin Plus Fluorouracil or Fluorouracil/Leucovorin plus oxaliplatin （mFOLFOX6）. Methods A total of 60 patients with advanced gastric cancers were induded in the retrospective study. Thirty - eight of them were in group DOF treated with Docetaxel and oxaliplatin Plus Fluorouracil, and the other 22 patients were in group mFOLFOX6 treated with Fluorouracil/Leucovorin plus oxaliplatin. Results All 60 cases were evaluable for objective response. The overall response rate was 38% in DOF group and 27% in mFOLFOX6 group. Median PFS （Progression- Free Survival） was 3.5 months in DOF group and 4.0 months in mFOLFOX6 group. In toxicities,grade 3 to 4 bone marrow suppression and alopecia were more frequent in group DOF than in group mFOLFOX6 （P 〈0. 05 ）. There was no significant difference in other toxicitics. Multivariate analyses suggested that Pathologic types and Karnofsky Performance Status were independent prognostic factors for PFS. Conclusion Both of the two regimens showed good curative effect and tolerable toxicities in the treatment of advanced gastric cancer. DOF regimen is more effective than mFOLFOX6 regimen with a higher response rate. Pathologic types and Karnofsky Performance Status were independent prognostic factors for PFS.