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目的观察多西紫杉醇联合奥沙利铂、卡培他滨方案与FOLFOX4方案治疗晚期胃癌的客观疗效,疾病进展时间和毒性反应。方法治疗组41例晚期胃癌患者接受多西紫杉醇25mg/m2(d1,d8,d15),奥沙利铂60mg/m2(d1,d8,d15),卡培他滨每日1250mg/m2,分2次口服,d1～14,28d为1周期,疗程2～6周期。对照组40例晚期胃癌患者接受奥沙利铂85mg/m2dl,亚叶酸钙200mg/m2(2h静脉输注)dl～d2,而后5-Fu400mg/m2(10min静脉推注)及5-Fu600mg/m2(持续静脉泵入22h),dl～d2,每14d重复,2次为1周期。结果多西紫杉醇联合奥沙利铂、卡培他滨方案治疗组总有效率为58.5%,中位疾病进展时间(TTP)为6.8个月。常见的毒性反应为白细胞和中性粒细胞减低,手足综合征和周围神经毒性反应等。FOLFOX4方案总有效率为47.4%,中位TTP为5.9个月。常见的毒性反应为白细胞和中性粒细胞减低和周围神经毒性反应等。结论多西紫杉醇联合奥沙利铂、卡培他滨化疗方案治疗晚期胃癌近期疗效显著,耐受性较好。
Objective To observe the objective efficacy, duration of disease and toxicity of docetaxel combined with oxaliplatin, capecitabine and FOLFOX4 regimen in the treatment of advanced gastric cancer. Methods 41 patients with advanced gastric cancer received docetaxel 25mg / m2 (d1, d8, d15), oxaliplatin 60mg / m2 (d1, d8, d15) and capecitabine daily 1250mg / m2, Oral administration, d1 ~ 14,28 d for the 1 cycle, treatment 2 to 6 cycles. Control group 40 patients with advanced gastric cancer received oxaliplatin 85mg / m2dl, leucovorin 200mg / m2 (2h intravenous infusion) dl ~ d2, then 5-Fu 400mg / m2 (10min intravenous injection) and 5-Fu600mg / m2 (Continuous intravenous infusion of 22h), dl ~ d2, repeated every 14d, 2 times for a cycle. Results The total effective rate of docetaxel plus oxaliplatin and capecitabine was 58.5% and the median time to progression (TTP) was 6.8 months. Common toxic reactions are leukopenia and neutropenia, hand-foot syndrome and peripheral neurotoxic reactions. The total effective rate of FOLFOX4 was 47.4% and the median TTP was 5.9 months. Common toxic reactions are leukopenia and neutropenia and peripheral neurotoxic reactions. Conclusion Docetaxel combined with oxaliplatin and capecitabine chemotherapy in the treatment of advanced gastric cancer has obvious curative effect and good tolerance.