论文部分内容阅读
目的:观察改良DCF方案(多西紫杉醇+顺铂+5-氟尿嘧啶)一线治疗晚期胃癌的疗效及不良反应。方法:对2008年6月—2011年6月收治的48例初治晚期胃癌患者,采用改良DCF方案化疗,即多西紫杉醇75 mg/m2静脉滴注(第1天),顺铂20 mg/m2静脉滴注(第1~3天),5-氟尿嘧啶750 mg/m2持续静脉滴注24 h(第1~5天)。21 d为1周期,至少2周期后进行疗效评价。结果:随访日期截止2013年2月,无失访病例。全组患者总有效率(ORR)为29.2%(14/48),疾病控制率(DCR)为87.5%(42/48),其中完全缓解(CR)1例(2.1%),部分缓解(PR)13例(27.1%),病情稳定(SD)28例(58.3%),病情进展(PD)6例(12.5%);中位疾病进展时间(TTP)为6.9个月,中位总生存期(OS)为12.5个月;不良反应为主要为骨髓抑制、消化道反应和脱发,粒细胞减低发生率为66.7%(32/48),其中III~IV度占21.8%(7/32),血小板减低发生率为20.8%(10/48),无III~IV度发生者;无严重感染、出血等治疗相关死亡。化疗后KPS评分是独立的预后影响指标。结论:改良DCF方案一线治疗晚期胃癌疗效确切,耐受性好。
Objective: To observe the efficacy and adverse reactions of modified DCF regimen (docetaxel + cisplatin + 5-fluorouracil) in the first-line treatment of advanced gastric cancer. Methods: Forty-eight patients with newly diagnosed advanced gastric cancer who were admitted to our hospital from June 2008 to June 2011 were treated with modified DCF chemotherapy (docetaxel 75 mg / m 2 intravenously (day 1), cisplatin 20 mg / m2 intravenous infusion (days 1 to 3), 5-fluorouracil 750 mg / m2 continuous intravenous infusion of 24 h (days 1 to 5). 21 d for a period of at least 2 cycles after the efficacy evaluation. Results: The follow-up date was February 2013, with no cases of loss of follow-up. The overall response rate was 29.2% (14/48) in the whole group, and the rate of disease control (DCR) was 87.5% (42/48). One group had complete remission (CR) ) Had 13 cases (27.1%) in stable condition (SD), 28 cases (58.3%) had stable condition (SD) and 6 cases (12.5%) had PD. The median time to progression (TTP) (OS) was 12.5 months. The main adverse reactions were myelosuppression, gastrointestinal reaction and alopecia. The incidence of neutrophil was 66.7% (32/48), with III-IV degree accounting for 21.8% (7/32) The incidence of thrombocytopenia was 20.8% (10/48), with no occurrence of III-IV degree; no serious infection, bleeding and other treatment-related deaths. KPS score after chemotherapy is an independent prognostic factor. Conclusion: The first-line treatment of advanced gastric cancer with modified DCF regimen is effective and well tolerated.