紫杉醇联合卡培他滨或氟尿嘧啶一线治疗晚期胃癌临床对照研究

Clinical comparsion between paclitaxel combined with capecitabine and fluorouracil in the first-line treatment of advanced gastric cancer

目的：观察紫杉醇联合卡培他滨或氟尿嘧啶治疗晚期胃癌的疗效和不良反应。方法：76例晚期胃癌行化疗患者随机分为观察组和对照组,各38例。观察组采用紫杉醇联合卡培他滨方案,紫杉醇150 mg/m2（总量,第1、8天）,加入0.9%氯化钠注射液,3 h缓慢静脉滴注;卡培他滨750 mg/m2,每天2次,第1~14天口服。对照组采用紫杉醇联合氟尿嘧啶方案,紫杉醇用法同观察组;氟尿嘧啶500 mg/m2,每天1次,连用5 d,使用前2 h静脉滴注亚叶酸钙130 mg/m2。结果：观察组总有效率52.63%,对照组50.00%,2组差异无统计学意义（P〉0.05）;观察组中位无进展时间6.7个月,中位生存时间11.8个月,对照组中位无进展时间6.2个月,中位生存时间11.3个月,2组1年生存率差异无统计学意义（P〉0.05）;观察组化疗主要不良反应中,手足综合征发生率明显高于对照组（P〈0.01）。结论：紫杉醇联合卡培他滨或氟尿嘧啶治疗晚期胃癌疗效相近,患者耐受性好。

Objective： To observe the effects and adverse reactions of paclitaxel combined with capecitabine or fluorouracil in the treatment of advanced gastric cancer. Methods： Seven-six patients with advanced gastric cancer were randomly divided into the observation group and control group（ 38 cases each group）. The observation group were treated with paclitaxel combined with capecitabine,the mixture of 150 mg / m2 of paclitaxel（ at day 1 and 8） and 0. 9% sodium chloride injection was intravenously injected for 3 h,and the 750 mg / m2 of capecitabine was used by oral 2 times daily from day 1 to 14. The control group were treated with paclitaxel combined with fluorouracil,the usage of paclitaxel was the same as the observation group,the 500 mg / m2 of 5-fluorouracil was used once a day for 5 d after 2 h of the 130 mg / m2 of leucovorin calcium intravenous dripping. Results： The effective rates of the observation group and control group were 52. 63%,and 50. 00%,respectively,the difference of which was not statistically significant（ P 〉0. 05）. The median progression-free time and median survival time in observation group and control group were 6. 7 months 11. 8 months and 6. 2 months 11. 3 months,respectively. The difference of 1-year survival rate between two groups was not statistically significant（ P 〉0. 05）. The incidence of hand-foot syndrome in observation group was significantly higher than that in control group（ P〈 0. 01）. Conclusions： The effects of paclitaxel combined with capecitabine or fluorouracil in the treatment of advanced gastric cancer are similar,the tolerance of patients is good.