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目的探讨周剂量多西他赛(docetaxe1,TXT)、顺铂(cisplatin,DDP)联合低剂量5-氟尿嘧啶持续滴注对晚期胃癌的疗效。方法 36例晚期胃癌患者中,20例为初治者(初治组),16例为复治者(复治组)。所有患者均采用多西他赛40mg/m2静脉滴注1h,第1、8天;顺铂20mg/m2静脉滴注,第1、2、8、9天;5-氟尿嘧啶1.25g/m2,第1、2、8、9天,持续静脉泵(Baxter泵)点滴共96h。21d为1个周期,至少2个周期后评价疗效。结果 36例患者中,32例可评价疗效,完全缓解(CR)l例,部分缓解(PR)l4例,稳定(SD)13例,进展(PD)4例,总有效率(RR)为46.8%。中位进展时间(TTP)为5.8个月,中位生存时间为8.3个月,1年生存率为15.6%。其中初治组有效率为55.6%(10/18),有1例CR;复治组有效率为35.7%(5/14),无CR病例,两组差异无统计学意义(P>0.05)。不良反应主要为骨髓抑制、消化道反应和脱发。大部分患者为I、Ⅱ度反应,耐受性良好。其中白细胞减少23例(63.9%),Ⅲ-Ⅳ度6例(16.7%)。结论多西他赛联合顺铂和5-氟尿嘧啶组成DCF方案周治疗进展期胃癌疗效较好,不良反应可以耐受,值得进一步探讨。
Objective To investigate the efficacy of weekly doses of docetaxel (docetaxe1, TXT), cisplatin (DDP) combined with low-dose 5-fluorouracil instillation on advanced gastric cancer. Methods Of the 36 patients with advanced gastric cancer, 20 were newly diagnosed (primary treatment group) and 16 were retreated (retreatment group). All patients were treated with docetaxel 40 mg/m 2 intravenously for 1 h on the 1st and 8th days; cisplatin 20 mg/m 2 for intravenous drip on the 1, 2, 8 and 9 days; 5-fluorouracil 1.25 g/m 2 1, 2, 8 and 9 days, continuous intravenous pump (Baxter pump) drip 96 hours. 21d is a cycle, and efficacy is evaluated after at least 2 cycles. Results Out of 36 patients, 32 cases were evaluated for efficacy, 1 case of complete remission (CR), 1 case of partial remission (PR), 13 cases of stable (SD), and 4 cases of progressive (PD). The total effective rate (RR) was 46.8. %. The median progression time (TTP) was 5.8 months, the median survival time was 8.3 months, and the 1-year survival rate was 15.6%. The effective rate was 55.6% (10/18) in the untreated group and 1 CR in the retreatment group. The effective rate in the retreatment group was 35.7% (5/14). There was no case of CR. There was no significant difference between the two groups (P>0.05) . Adverse reactions were mainly myelosuppression, gastrointestinal reactions and hair loss. Most of the patients had grade I and II reactions and were well tolerated. There were 23 cases (63.9%) of leucopenia and 6 cases (16.7%) of III-IV. Conclusion The combination of docetaxel combined with cisplatin and 5-fluorouracil (DCF) for the treatment of advanced gastric cancer is effective and can be well tolerated. It is worth further investigation.