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目的探讨多西他赛、奥沙利铂联合卡培他滨(DOX方案)与单纯奥沙利铂联合卡培他滨(XELOX方案)治疗晚期胃癌的临床疗效和不良反应。方法选取2010年1月至2013年1月间秦皇岛市第四医院收治的82例晚期胃癌患者,根据化疗方案分为DOX组和XELOX组,DOX组50例,XELOX组32例。DOX组患者采用奥沙利铂与卡培他滨联合多西他赛方案化疗;XELOX组患者采用奥沙利铂联合卡培他滨方案化疗。每化疗2周期后进行疗效评价,且每周期观察并记录不良反应,评价两组患者有效率(RR)、疾病控制率(DCR)和中位无进展生存期(PFS)。结果 DOX组患者中,完全缓解(CR)2例(4.0%),部分缓解(PR)24例(48.0%),病变稳定(SD)20例(40.0%),有效率(RR)为52.0%,DCR为92.0%,PFS为4.8个月。XELOX组患者中,CR 0例,PR 10例(31.3%),SD 17例(53.1%),RR为31.3%,DCR为84.4%,PFS为4.2个月。两组患者的总有效率、疾病控制率和中位无进展生存期差异均无统计学意义(均P>0.05)。化疗导致的主要不良反应为骨髓抑制、胃肠道反应、脱发和周围神经病变等,患者均可而授。结论 DOX和XELOX化疗方案治疗进展期胃癌疗效相近,不良反应均可耐受。
Objective To investigate the clinical efficacy and adverse reactions of docetaxel, oxaliplatin combined with capecitabine (DOX) and oxaliplatin combined with capecitabine (XELOX) in the treatment of advanced gastric cancer. Methods Eighty-two patients with advanced gastric cancer admitted to the Fourth Hospital of Qinhuangdao from January 2010 to January 2013 were divided into DOX group and XELOX group according to the chemotherapy regimen. Fifty patients in DOX group and 32 in XELOX group were enrolled in this study. Patients in DOX group were treated with oxaliplatin combined with capecitabine in combination with docetaxel chemotherapy. Patients in XELOX group were treated with oxaliplatin plus capecitabine chemotherapy. The therapeutic effect was evaluated after 2 cycles of chemotherapy. The adverse reactions were observed and recorded every cycle. The RR, DCR and PFS of the two groups were evaluated. Results In DOX group, there were 2 cases (4.0%) of complete remission (CR), 24 cases (48.0%) of partial remission (PR) and 20 cases (40.0%) of stable disease (SD) DCR was 92.0% and PFS was 4.8 months. In the XELOX group, CR 0, PR 10 (31.3%) and SD 17 (53.1%) had RR of 31.3%, DCR 84.4%, and PFS 4.2 months. There was no significant difference in the total effective rate, disease control rate and median progression-free survival between the two groups (all P> 0.05). The main adverse reactions caused by chemotherapy for bone marrow suppression, gastrointestinal reactions, hair loss and peripheral neuropathy, patients can be granted. Conclusions The efficacy of DOX and XELOX chemotherapy in treating advanced gastric cancer is similar, and adverse reactions can be tolerated.