紫杉醇脂质体联合顺铂治疗晚期胃癌35例临床观察

Liposomal paclitaxel plus cisplatin therapy for advanced gastric cancer: A clinical observation of 35 cases

目的探讨紫杉醇脂质体联合顺铂治疗晚期胃癌的临床疗效及不良反应，为临床诊疗提供参考。方法35例初治的晚期胃癌患者均给予紫杉醇脂质体135mg／m^2，第1天静脉滴注3h，顺铂25mg／m^2静脉滴注，d1～3，每周期21d，至少连用2周期。按RECIST1．0标准对治疗效果及不良反应进行评价。结果完全缓解2例，部分缓解16例，病变稳定4例，疾病进展13例，客观有效率为51．43％，疾病控制率为62．86％；疾病中位进展时间为7．4个月，中位生存时间为15．3个月；血液学毒性是其最常见的不良反应，白细胞Ⅲ～Ⅳ度降低发生率为14．29％，无化疗相关死亡病例；其余胃肠道反应、脱发等均以Ⅰ～Ⅱ度为主。结论紫杉醇脂质体联合顺铂治疗晚期胃癌临床疗效好，不良反应小，值得进一步扩大样本量进行深入研究。

Objective To explore the clinical efficacy of liposomal paclitaxel in combination with cisplatin in patients with advanced gastric cancer and adverse reactions and to provide reference for clinical diagnosis. Methods 35 cases of previously untreated patients with advanced gastric cancer were treated with liposomal paclitaxel 135mg/ m^2,the first day intravenous infusion 3h;Cisplatin 25mg/m^2 itravenous infused,d1-3,21d per period,at least 2 cycles.Treatment effects and adverse reactions were evaluated by RECIST1.0 standard. Results Two cases were complete remission, 16 cases were partial remission,4 cases were stable,13 cases were disease progression, and objective response rate was 51.43%, disease control rate was 62.86%;The median time to progression of disease was 7.4 months,and the median survival time was 15.3 months; Hematologic toxicity was the most common adverse reactions,WBC Ⅲ - Ⅳ degrees lower incidence was 14.29%,and no chemotherapy-related deaths; The remaining gastrointestinal reactions,alopecia degree were main Ⅰ - Ⅱ. Conclusion Liposomal paclitaxel plus cisplatin therapy for advanced gastric cancer shows good clinical efficacy,with less adverse reactions,worthy of further expanding the sample size in-depth study.