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[目的]观察紫杉醇脂质体联合奥沙利铂、氟尿嘧啶方案(POF)治疗晚期胃癌的临床疗效和不良反应。[方法]对48例晚期胃癌患者采用POF方案治疗,具体用法:紫杉醇脂质体135mg/m2,第1d静滴3h;奥沙利铂135mg/m2,第2d静滴2h;氟尿嘧啶500mg/m2,化疗泵内持续推注,d1～5。21d为1个周期,每2个周期评价疗效。[结果]48例患者均可评价疗效及毒性,其中完全缓解(CR)2例(4.2%),部分缓解(PR)23例(47.9%),稳定(SD)14例(29.2%),进展(PD)9例,总有效率(RR)52.1%,中位疾病进展时间(TTP)6.2个月,中位生存时间(MST)11.5个月。临床受益反应评价总有效率75.0%(36/48)。不良反应主要是骨髓抑制和消化道反应,Ⅲ～Ⅳ度骨髓抑制发生率为22.9%;其他外周神经毒性、肌肉酸痛、脱发,多为Ⅰ～Ⅱ度;无化疗相关性死亡病例。[结论]紫杉醇脂质体联合奥沙利铂、氟尿嘧啶(POF)治疗晚期胃癌的疗效确切,不良反应患者能够耐受,可以作为晚期胃癌的一线或二线治疗方案。
[Objective] To observe the clinical efficacy and side effects of paclitaxel liposome combined with oxaliplatin and fluorouracil (POF) in the treatment of advanced gastric cancer. [Methods] Forty - eight patients with advanced gastric cancer were treated with POF regimen. The specific usage was as follows: paclitaxel liposome 135mg / m2, intravenous infusion 3h on the first day, oxaliplatin 135mg / m2, intravenous drip 2d on the second day, fluorouracil 500mg / m2, Continuous bolus chemotherapy pump, d1 ~ 5.21d for a cycle, evaluation of the efficacy of every 2 cycles. [Results] The curative effect and toxicity of 48 patients were evaluated. Among them, 2 cases (4.2%) were complete remission (CR), 23 cases (47.9%) were partial remission (PR), 14 cases (29.2%) were stable (PD) in 9 cases. The total effective rate (RR) was 52.1%. The median time to progression (TTP) was 6.2 months. The median survival time (MST) was 11.5 months. Evaluation of clinical benefit response rate was 75.0% (36/48). Adverse reactions were mainly myelosuppression and gastrointestinal reactions. The incidence of grade Ⅲ ~ Ⅳ myelosuppression was 22.9%. Other peripheral neurotoxicity, muscle soreness and hair loss were mostly grade Ⅰ ~ Ⅱ. There were no chemotherapy-related deaths. [Conclusion] paclitaxel liposome combined with oxaliplatin and fluorouracil (POF) has definite therapeutic effect on advanced gastric cancer and patients with adverse reactions can tolerate it. It can be used as a first-line or second-line treatment for advanced gastric cancer.