改良DOC联合DDP和5-FU一线治疗晚期胃癌及胃食管结合部癌的临床观察

Modified DCF regimen as first-line chemotherapy for patients with advanced gastric and esophago-gastric junction cancer

目的探讨多西他赛(docetaxel,DOC)联合顺铂(DDP)和5-氟尿嘧啶(5-FU)一线治疗晚期胃癌和胃食管结合部癌的临床疗效和不良反应。方法回顾性分析80例晚期胃癌及胃食管结合部癌患者,接受改良双周DCF方案化疗;具体为多西他赛37.5 mg/m2第1、8天静脉滴注;顺铂20 mg/m2第1-2、8-9天静脉滴注;5-氟尿嘧啶1.0 g/m2第1、8天用药,每次微泵持续静脉滴注48小时,21天为1周期,治疗≥2周期,分析其疗效和不良反应。结果 78例患者接受平均4.7周期(2-11周期)的改良双周DCF方案的化疗,均无化疗相关性死亡,总有效率为35.9%(28/78);疾病控制率为78.2%(61/78),中位疾病进展时间为5.0月(95%CI:4.3-5.7月),中位生存时间8.9月(95%CI:6.8-11.0月);1年的生存率33.3%(26/78)。结论对于不能耐受3周方案的晚期胃癌及胃食管结合部癌患者,采用改良双周DCF方案一线治疗疗效肯定且不良反应可耐受,值得临床进一步应用。

Objective To evaluate the efficacy and safety of modified docetaxel,cisplatin and 5-fluorouracil（ mDCF） regimen for patients with advanced gastric and esophago-gastric junction cancer. Methods The clinical data of80 patients with advanced gastric and esophago-gastric junction cancer undergoing two-week mDCF as first-line chemotherapy were retrospectively analyzed. A total dose of 37. 5 mg/m2 docetaxel was given i. v. at d1 and d8,20 mg/m2 cisplatin i. v. at d1- 2 and d8- 9,1 000 mg/m25-fluorouracil（ 5-FU） was continuously infused for 48 h with 21 d as a cycle. All patients were treated more than two cycles. Clinical efficacy and safety were evaluated. Results Seventy-eight patients were evaluable for efficacy and toxicity. Objective response rate（ ORR） was 35. 9%（ 28/78）,disease control rate（ DCR） was 78.2%（ 61/78）,median time to progression（ TTP） was 5.0 months（ 95% CI： 4.3 ～5.7 months）,median overall survival time（ OS） was 8. 9 months（ 95% CI： 6. 8- 11. 0 months） and 1-year survival rate was 33. 3%（ 26/78）.There was no chemotherapy-related fatality. Conclusion For patients with advanced gastric and esophago-gastric junction cancer,mDCF regimen demonstrates certain efficacy with minimal toxicity,suggesting that the modified regimen can be used as first-line chemotherapy for patients who may not tolerate to standard DCF regimen.