DCF方案与ECF方案治疗进展期胃癌的临床研究

A clinical study of DCF scheme and ECF scheme in the treatment of advanced gastric cancer

目的探讨DCF方案（多西紫杉醇＋顺铂＋5-氟尿嘧啶）与ECF方案（表柔比星＋顺铂＋5-氟尿嘧啶）治疗进展期胃癌的临床疗效及不良反应。方法选择进展期胃癌患者62例，按数字表格法随机分为DCF组和ECF组，每组31例。DCF组给予DCF方案化疗，ECF组给予ECF方案化疗，至少完成2个化疗周期后进行疗效评价。结果DCF组完全缓解2例、部分缓解10例、病情稳定11例、病情进展8例，治疗有效率为38．71％（12／31）；ECF组完全缓解1例、部分缓解9例、病情稳定10例、病情进展11例，治疗有效率为32．260／0（10／31），两组治疗有效率比较差异无统计学意义（r=0．28，P〉0．05）。DCF组中位无进展时间为5．9个月，ECF组为5．7个月。两组化疗期间不良反应主要以骨髓抑制、消化道反应及周围神经炎多见，以1、2度为主，两组血红蛋白下降、白细胞下降、血小板下降、口腔炎、恶心呕吐、腹泻发生率比较差异均无统计学意义（P〉0．05），DCF组周围神经炎发生率明显高于ECF组[77．42％（24／31）比9．68％（3／31），P〈0．05]。结论DCF方案与ECF方案治疗进展期胃癌疗效均较为满意，不良反应以1、2度为主，DCF方案患者周围神经炎发生率高，但均可耐受。

Objective To investigate the clinical effect and adverse reactions of DCF scheme （docetaxel ＋ cisplatin ＋ 5- fluorouracil） and ECF scheme （epirubicin ＋ cisplatin ＋ 5- fluorouracil） in the treatment of advanced gastric cancer. Methods Sixty-two patients with advanced gastric cancer were randomly divided into two groups with 31 cases each, DCF group was given DCF scheme therapy, ECF group was given ECF scheme therapy. After completing at least 2 cycles of chemotherapy the curative effect was evaluated. Results DCF group complete response in 2 patients, partial response in 10 patients, stable condition in 11 patients, disease progression in 8 cases, the effective rate was 38.71% （ 12/31 ）, ECF group complete response in 1 patient, partial response in 9 patients, stable condition in 10 patients, disease progression in 11 patients, the effective rate was 32.26% （ 10/31 ）, there was no significant difference in the effective rate between the two groups （X^2 = 0.28 ,P 〉 0.05 ）. The median progression-free time in DCF group was 5.9 months, ECF group was 5.7 months .Two groups during the period of chemotherapy adverse reactions mainly in bone marrow suppression, gastrointestinal reactions and peripheral neuritis, were given priority to with 1, 2 degrees. There were no significant difference in hemoglobin decline rate, white blood cells, platelets drop incidence rate of descent, stomatitis incidence, nausea and vomiting, diarrhea incidence rate between two groups （P 〉 0.05）. Peripheral neuritis in DCF group was obviously higher than that in ECF group [77.42%（24/31） vs. 9.68%（3/31）,P〈0.05]. Conclusion DCF scheme and ECF scheme in the treatment of advanced gastric cancer are relatively satisfied curative effect, adverse reaction is given priority to with 1, 2 degrees, DCF scheme of peripheral nerve inflammation in patients with a high incidence, but all can tolerate.