紫杉醇为主化学治疗方案治疗中晚期胃癌的临床疗效分析

Clinical study of liposome paclitaxel-based chemotherapy in the treatment of advanced gastric cancer

目的：探讨脂质体紫杉醇联合顺铂、氟尿嘧啶和奥沙利铂联合氟尿嘧啶的化学治疗方案治疗中晚期胃癌的临床疗效及其不良反应。方法选取94例中晚期胃癌患者，随机分为研究组和对照组，每组各47例，研究组采用脂质体紫杉醇联合顺铂、氟尿嘧啶的化学治疗方案，对照组采用奥沙利铂联合氟尿嘧啶化学治疗方案，所有患者至少行化学治疗2个周期，化学治疗2～6个周期后评价其临床疗效及其不良反应。结果两组的客观反应率（ORR）分别为53％和49％，疾病控制率（DCR）分别为79％和74％，2组在ORR、DCR、中位生存期以及1年生存率方面比较差异均无统计学意义（P均＞0．05）。研究组的不良反应主要为脱发以及血液学毒性，而对照组的不良反应主要为外周神经毒性，均可耐受，不影响继续治疗。结论以脂质体紫杉醇为主的联合化学治疗方案治疗中晚期胃癌取得了较好的近期和远期疗效，且患者对毒副作用均可以耐受。

Objective To compare the clinical efficacy and adverse responses between liposome pa-clitaxel combined with cisplatin and 5-fluorouracil chemotherapy and oxaliplatin in combination with 5-fluorou-racil chemotherapy in the treatment of advanced gastric cancer. Methods A total of 94 patients with advanced gastric cancer were randomly divided into the study （n=47）and control groups （n=47）. Liposome paclitaxel combined with cisplatin and 5-fluorouracil chemotherapy was adopted in the study group and oxaliplatin com-bined with 5-fluorouracil chemotherapy in the control group. All patients underwent at least two cycles of chem-otherapy. Clinical efficacy and adverse reactions were evaluated after 2-6 cycles of chemotherapy. Results The objective response rates of the study and control groups were 53%and 49%,and the disease control rates were 79%and 74%. Objective response rate,disease control rate,median and one-year survival rates did not significantly differ between the two groups （all P〉0. 05 ）. Hair loss and hematologic toxicity were the main ad-verse reactions in the study groupand peripheral neurotoxicity in the control group,which could be tolerated and did not affect subsequent treatment. Conclusions Liposome paclitaxel combined with 5-fluorouracil and cispl-atin chemotherapy presented with high short,long-term clinical efficacy and well tolerated in the treatment of advanced gastric cancer.