多西他赛或奥沙利铂联合5-氟尿嘧啶治疗晚期胃癌的临床效果研究

The clinical effect of docetaxel or oxaliplatin combined with 5-fluorouracil in the treatment of advanced gastric cancer

目的探讨多西他赛或奥沙利铂联合5-氟尿嘧啶(5-fluorouracil,5-FU)治疗晚期胃癌的近、远期疗效。方法将2010年5月至2015年4月渭南市中心医院收治的116例晚期胃癌患者依据其最终接受的化疗方案不同分为A、B、C三组。A组患者40例,采用多西他赛联合5-FU化疗方案;B组患者39例,采用奥沙利铂联合5-FU化疗方案;C组患者37例,采用多西他赛、奥沙利铂、5-FU三联化疗方案。三组患者均接受至少2个周期的化疗,且治疗2周后评定近期疗效,同时评估临床受益反应(clinical benefit response,CBR)和化疗相关不良反应发生情况。三组患者均随访至化疗结束后1年。结果 C组患者的客观缓解率和疾病控制率(67.6%、89.2%)均高于A组(42.5%、67.5%)和B组(43.6%、69.2%)(P<0.05),但A组和B组比较无显著差异(P>0.05)。C组患者的疾病稳定持续时间、1年无不良事件生存期和生存率虽然略优于A组和B组,但差异均无显著性(P>0.05)。三组CBR评价为有效者占比无显著差异(P>0.05)。C组患者骨髓抑制发生率明显高于A组和B组(P<0.05),其他不良反应发生率三组间比较均无显著差异(P>0.05)。结论三联化疗方案虽能获得显著的短期疗效,但患者不良反应较大,且未见显著的长期获益。3种化疗方案患者均可耐受,故应根据晚期胃癌患者的个体情况进行合理选择。

Objective To explore the nearly and forward curative effect ofdocetaxel or oxaliplatin combined with 5-fluorouracil （5-FU） in the treatment of advanced gastric cancer. Method 116 cases of patients with advanced gastric cancer from May 2010 to April 2015 in the Center Hospital of Weinan were divided into group A, B, C. 40 patients in group A with were treated with docetaxel combined with 5-FU; 39 patients in group B were treated with oxaliplatin and 5-FU; 37 patients in group C were treated with docetaxel and oxaliplatin combined with 5-FU. All patients were treated at least 2 cycles of chemotherapy, and the evaluation of the recent curative effect was compared after 2 weeks, and the clinical practice response, chemotherapy related adverse reactions were evaluated. Patients in three groups were followed up to one year after chemotherapy. Result The objective response rate and disease control rate of group C （67.6%, 89.2%） were higher than group A （42.5%, 67.5%） and group B （43.6%, 69.2%） （P 〈 0.05）, but there was no significant difference between group A and group B （P 〉 0.05）. The stable disease duration, no adverse events survival and one year surviva! rate although slightly better than group A and group B, but there were no significant difference （P 〉 0.05）. CBR evaluation for effective of three groups had no significant difference （P 〉 0.05）. The bone marrow inhibition rate in group C was obviously higher than group A and group B （P 〈 0.05）, and other adverse reactions incidence among three groups had no significant differences （P 〉 0.05）. Conclusion The three chemotherapy regimens can get significant short-term curative effect, but adverse reaction is bigger, there is no significant long-term benefit. Patients can tolerate with three kinds of chemotherapy, so we should make reasonable choice depends on the individual situation of patients with advanced gastric cancer.