DCF方案一线治疗进展期胃癌的临床疗效观察

Docetaxel, cisplatin and 5-fluorouracil as initial therapy for patients with advanced gastric cancer

目的 观察DCF方案（多西他赛＋顺铂＋氟尿嘧啶）一线治疗进展期胃癌的临床疗效和不良反应.方法 收集我院2007年7月至2011年2月经病理和影像学确诊的61例进展期胃癌患者的临床资料进行回顾性分析.DCF方案：多西他赛75 mg/m2静脉滴注,第1天；氟尿嘧啶750 mg/m2持续静脉滴注24h,用化疗泵持续静脉滴注120 h（第1～5天）；顺铂75 mg/m2第1天静脉滴注,所有患者至少用药3个周期.对近期客观疗效及不良反应进行评价.结果 治疗有效率为34.4％（21/61）,疾病控制率为82.0％（50/61）,中位无疾病进展时间为6.2个月,中位总生存期为10.1个月.中性粒细胞减少发生率为86.9％（53/61）,其中Ⅲ～Ⅳ级为72.1％ （44/61）,恶心呕吐发生率为80.3％（49/61）,Ⅲ～Ⅳ级占18.0％（11/61）.结论 DCF方案一线治疗进展期胃癌疗效较好,但骨髓抑制毒副作用较明显,可以作为一般状态较好的进展期胃癌患者有效化疗方案的选择.

Objective To evaluate the efficacy and tolerability of paclitaxel combined with cisplatin and fluorouracil （DCF） regimen as first line therapy for advanced gastric cancer （AGC）. Methods Data from sisty-one patients treated with docetaxel with a dose of 75 mg/m2 on Day 1, cisplatin with a dose of 75 mg/m2 on Day 1 and infusional 5-fluorouracil with a dose of 750 mg/（m2·day） on Days 1 to 5 （DCF） regimen. All the cases received DCF for at least 3 cycles and efficacy can be evaluated as well. Results The response rate （RR） was 34.4% and the disease control rate （DCR） was 82.0%. The median progTession-free time（mPFS）and median overall survival time （OS） were 6.2 and 10.1 months respectively. 72.1% of cases developed treatment-related grade 3 or 4 granulocytopenia. Conclusion DCF regimen is effective but with high hematologic toxicity rate and it can be a promising therapy for AGC cases.