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目的评价紫杉醇联合卡培他滨一线治疗老年晚期或转移性胃癌的疗效及毒副反应。方法采用紫杉醇80mg/m2,静脉滴注3h,第1、8天;卡培他滨2000mg/m2,分两次口服,连用14d,每3周重复,至少连用2周期后评价疗效。结果32例可评价疗效,其中完全缓解1例(3.1%),部分缓解17例(53.1%),稳定10例(31.3%),进展4例(12.5%),有效率RR:56.3%(18/32),中位疾病进展时间:6.2个月,中位生存期11.8个月,1年生存率为43.5%,临床受益率为75%。主要不良反应为骨髓抑制及胃肠道反应,多为Ⅰ度和Ⅱ度毒副反应,其他有肌肉酸痛、脱发、手足综合征等。所有患者无化疗相关死亡。结论紫杉醇联合卡培他滨方案一线治疗老年晚期或转移性胃癌疗效确切,不良反应可耐受,值得进一步临床研究。
Objective To evaluate the efficacy and side effects of paclitaxel plus capecitabine in the treatment of elderly patients with advanced or metastatic gastric cancer. Methods paclitaxel 80mg / m2, intravenous infusion 3h, first and eighth days; capecitabine 2000mg / m2, two oral, once every 14d, repeated every 3 weeks, at least 2 weeks after the evaluation of efficacy. RESULTS: Thirty-two patients (31%) had complete remission (31.1%), partial response rate was 11.3% (31.3%), 4 patients (12.5% / 32). The median time to progression was 6.2 months. The median survival time was 11.8 months. The 1-year survival rate was 43.5% and the clinical benefit rate was 75%. The main adverse reactions were myelosuppression and gastrointestinal reactions, mostly degree Ⅰ and Ⅱ degree side effects, other muscle soreness, hair loss, hand-foot syndrome. All patients had no chemotherapy-related death. Conclusion paclitaxel combined with capecitabine first-line treatment of elderly patients with advanced or metastatic gastric cancer is indeed effective, adverse reactions are tolerable, worthy of further clinical studies.