紫杉醇联合奥沙利铂和氟尿嘧啶治疗晚期胃癌的疗效观察

Efficacy of paclitaxel combined with oxaliplatin and 5-fluorouracil for the treatment of advanced gastric cancer

目的探讨紫杉醇联合奥沙利铂和氟尿嘧啶(P0F方案)治疗晚期胃癌的疗效与安全性。方法 28例晚期胃癌患者采用P0F方案进行化疗:紫杉醇85 mg/m2,第1,8天,静脉滴注;奥沙利铂130mg/m2,第1天,静脉滴注;氟尿嘧啶500 mg/m2,第1至第5天,静脉滴注。21天为1个周期,2个周期评价疗效。患者在治疗前和治疗后均接受生存质量量表(QOL)测评,并记录患者在治疗后的不良反应。结果 28例患者的总有效率为67.9%,其中初治患者15例,有效率为80.0%,复治患者13例,有效率为53.8%,两者之间差异有统计学意义(P<0.05)。治疗后患者的躯体、情绪、认知、疼痛及社会功能分值均高于治疗前,且差异有统计学意义(P<0.05)。治疗2个周期后,主要的不良反应为骨髓抑制、胃肠道反应和外周神经毒性等,经对症治疗后,患者均能耐受。结论晚期胃癌患者采用紫杉醇、奥沙利铂和氟尿嘧啶联合治疗,可提高疗效,且不良反应可对症治疗,值得临床进一步推广。

Objective To investigate the efficacy and safety of paclitaxel, oxaliplatin and fluorouracil （POF regimen） for the treatment of advanced gastric cancer. Methods A total of 28 patients with ad- vanced gastric cancer accepted POF regimen for 2 cycles, with paclitaxel 8 5mg/m2 intravenously d 1, d 8; oxaliplatin 130 mg/m2 intravenously d 1, and 5- fluorouracil 500 mg/m2 intravenously from day 1 to day 5, 21d as a cycle. Before and after therapy, patients were proceded with quality of life scale （QOL） assessment and side effects recording in the fourth weekend. Results Of the 28 patients, the overall response rate was 67.9%. The response rate of untreated patients （ 15 cases） and retreated patients （ 13 cases） was 80. 0% and 53.8%, respectively. The difference was statistically significant （ P 〈 0.05 ）. After therapy, the emotional, cognitive, physical pain and social function scores of patients were higher than that before therapy. The difference was statistically significant （P 〈 O. 05 ）. The major side effects were myelosuppression, gastrointestinal reactions and neutropenia. Conclusions Paclitaxel, oxaliptatin and fluorouracil （POF regimen） combination therapy is a safe and effective regimen for the patients with advanced gastric cancer, it is worthy to be popularized.