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目的:观察多西他赛联合奥沙利铂和5-氟尿嘧啶(5-Fu)方案治疗晚期胃癌的近期疗效、毒副反应及生存状况。方法:收集2004-2010年我院41例晚期胃癌患者,多西他赛75 mg.m-2(d 1);奥沙利铂130 mg.m-2(d 2);5-Fu 400～500 mg.m-2.d-1,[d 2～d 5或持续泵入96 h(civ 96 h)],每21 d重复1次,至少2个周期。结果:总缓解率(ORR)为26.8%,疾病控制率(DCR)为78.0%。中位无进展生存期(PFS)为5.6个月(95%CI:3.52～7.6),中位总生存(OS)为12.3个月(95%CI:2.7～21.9)。1年生存率为46.3%(19/41);2年生存率为21.9%(9/41);3年生存率为7.3%(3/41)。常见的毒副反应为骨髓抑制(主要为白细胞及中性粒细胞减少)、胃肠道反应(恶心和呕吐)、腹泻和脱发等。结论:多西他赛联合奥沙利铂和5-FU方案治疗晚期胃癌疗效显著,毒副反应可耐受。化疗近期疗效是晚期胃癌PFS和OS的独立预后因素[危害比(HR):3.6;95%CI:1.8～7.3]。
Objective: To observe the short-term efficacy, toxicity and survival status of docetaxel combined with oxaliplatin and 5-fluorouracil (5-Fu) regimen in the treatment of advanced gastric cancer. METHODS: Forty-one patients with advanced gastric cancer in our hospital during 2004-2010 were collected. Docetaxel 75 mg.m-2(d 1); Oxaliplatin 130 mg.m-2(d 2); 5-Fu 400- 500 mg.m-2.d-1, [d 2 to d 5 or continuous pumping for 96 h (civ 96 h)], repeated every 21 d for at least 2 cycles. Results: The total remission rate (ORR) was 26.8%, and the disease control rate (DCR) was 78.0%. The median progression-free survival (PFS) was 5.6 months (95% CI: 3.52 to 7.6), and the median overall survival (OS) was 12.3 months (95% CI: 2.7 to 21.9). The 1-year survival rate was 46.3% (19/41); the 2-year survival rate was 21.9% (9/41); the 3-year survival rate was 7.3% (3/41). Common toxicities are bone marrow suppression (mainly leukocytes and neutropenia), gastrointestinal reactions (nausea and vomiting), diarrhea, and hair loss. Conclusion: The efficacy of docetaxel combined with oxaliplatin and 5-FU regimen in the treatment of advanced gastric cancer is significant, and toxic and side effects can be tolerated. The short-term curative effect of chemotherapy is an independent prognostic factor for advanced gastric cancer PFS and OS [hazard ratio (HR): 3.6; 95% CI: 1.8-7.3].