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目的:探讨多西他塞联合奥沙利铂、氟尿嘧啶和亚叶酸钙治疗Ⅲ、Ⅳ期胃癌后再手术的临床疗效。方法:对2005年1月～2008年8月期间40例Ⅲ、Ⅳ期胃癌患者,第1天应用多西他塞60mg/m2、奥沙利铂75mg/m2;第1～5天氟尿嘧啶500mg/m2、亚叶酸200mg/m2,每4周为1个周期,共2～3个周期,化疗结束4～6周后手术。结果:总有效率70%,病理客观有效率85%,根治性切除率62.5%。主要不良反应:骨髓抑制和恶心、呕吐。没有严重的化疗并发症;疾病进展时间(TTP)6.4个月,中位生存期(MST)20.6个月。结论:多西他塞联合奥沙利铂、氟尿嘧啶和亚叶酸钙方案治疗Ⅲ、Ⅳ期胃癌后再手术可以提高手术的根治率和切除率,并且具有较好的安全性和依从性。
Objective: To investigate the clinical effect of docetaxel combined with oxaliplatin, fluorouracil and leucovorin in the reoperation of stage Ⅲ and Ⅳ gastric cancer. Methods: From January 2005 to August 2008, 40 patients with stage Ⅲ and Ⅳ gastric cancer were treated with docetaxel 60 mg / m 2 and oxaliplatin 75 mg / m 2 on the first day, fluorouracil 500 mg / m2, leucovorin 200mg / m2, every 4 weeks for a period of 2 to 3 cycles, 4 to 6 weeks after the end of chemotherapy surgery. Results: The total effective rate was 70%, the pathological objective efficiency was 85% and the radical resection rate was 62.5%. The main adverse reactions: myelosuppression and nausea, vomiting. There were no serious complications of chemotherapy; the duration of disease (TTP) was 6.4 months and the median survival time (MST) was 20.6 months. Conclusion: Docetaxel combined with oxaliplatin, fluorouracil and leucovorin regimen in the treatment of stage Ⅲ and Ⅳ gastric cancer reoperation can improve the cure rate and resection rate, and has good safety and compliance.