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目的评估紫杉醇脂质体联合大剂量5-氟尿嘧啶(5-FU)持续静脉滴注治疗进展期胃癌的疗效和不良反应。方法选择我院普外科2009年5月至2012年8月期间收治的63例进展期胃癌患者,给予紫杉醇脂质体联合大剂量(2.5 g/m2)5-FU持续静脉滴注治疗。依据RECIST标准进行疗效评价,并观察该化疗方案的不良反应。结果无一例患者因严重化疗毒性反应不能耐受而终止治疗。63例患者中达到完全缓解5例(7.94%),部分缓解31例(49.2%),总体有效率为57.1%(36/63)。血液学毒性反应中Ⅲ/Ⅳ级白细胞减少、中性粒细胞减少分别为8例(12.7%)和10例(15.9%),没有发生Ⅲ/Ⅳ级的贫血或血小板减少。非血液学毒性反应相对较轻,基本为Ⅰ/Ⅱ级反应。结论紫杉醇脂质体具有安全性高、耐受性好、靶向性高和长时疗效的特点。紫杉醇脂质体联合大剂量5-FU持续静脉滴注治疗进展期胃癌临床疗效确切、不良反应较轻、患者耐受性好。
Objective To evaluate the efficacy and adverse effects of paclitaxel liposomes in combination with high-dose 5-fluorouracil (5-FU) continuous intravenous infusion in the treatment of advanced gastric cancer. Methods Sixty-three patients with advanced gastric cancer admitted to our department from May 2009 to August 2012 were enrolled in this study. Paclitaxel liposome combined with high-dose (2.5 g / m2) 5-FU continuous intravenous infusion was given. The curative effect was evaluated according to RECIST criteria and the adverse reactions of the chemotherapy regimen were observed. Results None of the patients discontinued treatment because of severe chemotherapy toxicity. Among 63 patients, complete remission was achieved in 5 cases (7.94%), partial remission in 31 cases (49.2%), and overall response rate was 57.1% (36/63). In hematologic toxicity, grade Ⅲ / Ⅳ neutropenia and neutropenia were found in 8 cases (12.7%) and 10 cases (15.9%) respectively. No grade Ⅲ / Ⅳ anemia or thrombocytopenia occurred. Non-hematological toxicity is relatively mild, the basic class Ⅰ / Ⅱ reaction. Conclusion paclitaxel liposomes with high safety, good tolerance, high targeting and long-term efficacy characteristics. Paclitaxel liposomes combined with high-dose 5-FU sustained intravenous infusion of advanced gastric cancer clinical curative effect, mild adverse reactions, patients with good tolerance.