【摘要】 目的比较多西他赛联合国产替吉奥(维康达)和其他化疗方案治疗晚期胃癌的疗效及不良反应,探讨晚期胃癌的合理治疗。方法回顾性分析2009年6月至2011年4月89例晚期胃癌的治疗情况,根据患者接受治疗方案不同分为3组。多西他赛联合替吉奥组(DT组):多西他赛75mg/m2,第1天,替吉奥80mg/m2,分两次饭后口服,第1~14天,21天为1个周期;常规化疗组:多西他赛75mg/m2,第1天,奥沙利铂130mg/m2,第2天(DO组),或顺铂(70mg/m2,第2天)+5-氟尿嘧啶2.5g/m2,46小时持续泵入(DCF组),21天为1个周期;记录临床近期疗效及不良反应,观察3个周期后进行统计分析。结果DO组、DCF组、DT组中位无进展生存(PFS)分别为4.8、11.4、12.5个月,3组患者中位PFS比较,差异有统计学意义(P<0.05)。89例患者均可评价疗效,DT组疾病控制率为58.1%(18/31),DO组为46.4%(13/28),DCF组为53.3%(16/30),3组比较差异无统计学意义(P>0.05),临床有效率3组间差异亦无统计学意义(P>0.05),DT组不良反应主要为恶心、腹泻和骨髓抑制等,DO和DCF组不良反应主要为骨髓抑制、胃肠道反应和手足综合征等,DT组不良反应明显低于其他两组(P<0.05)。结论多西他赛联合替吉奥治疗晚期胃癌具有较高的临床有效率,不良反应较轻,尤其是身体状况较差的晚期老年患者。更多还原

【Abstract】 Objective This study intends to compare docetaxel combined Wei Kang Da and other chemotherapy in the treatment of advanced gastric cancer for efficacy and toxicity,rational treatment.Methods Eighty-nine cases of advanced gastric cancer with different treatments from June 2009to April 2011in our hospital were retrospectively analyzed.The patients were divided into three groups according to different regimens:docetaxel combined for Wei Kang Da group(DT group)and DO/DCF group.DT group:received Wei Kang Da 80mg/m2,orally during the meal twice a day,d1-14,docetaxel 75mg/m2,d1,21day for a cycle;conventional chemotherapy:DO/DCF group,21day for a cycle,docetaxel(75mg/m2,d1)+ oxaliplatin(130mg/m2,d2)or cisplatin(70mg/m2,d2)and 5-fluorouracil(2.5g/m2,46-hour continuous infusion).The clinical efficacy and toxicity were observed after three cycles.Results The median of progression-free survival in groups DO,DCF,DT were 4.8,11.4,12.5 months,respectively,there were significant difference in the comparisons(P<0.05).Totally 89patients were evaluated for efficacy.In DT group,the disease control rate was 58.1%(18/31),in DO group,it was 46.4%(13/28),DCF group,53.3%(16/30),three groups showed no significance in comparison(P >0.05),the clinical efficiency of three groups also showed no statistic significance(P >0.05).The main toxicities of DT group were such as nausea,diarrhea,and bone marrow suppression,and the main toxicities of DO and DCF groups were bone marrow suppression,gastrointestinal reactions and hand-foot syndrome and others.The side effects were significantly less in DT group compared with the other two groups(P<0.05).Conclusion The regimen of docetaxel combined Wei Kang Da in the treatment of advanced gastric cancer shows high clinical efficacy,less toxicity,especially in poor physical condition of elderly patients.更多还原