【摘要】 目的探讨改良DCF方案与FOLFOX 4方案一线治疗晚期胃癌的疗效和安全性。方法收集本院2010年1月至2013年7月收治的晚期胃癌患者47例,根据化疗方案分为改良DCF组(多西他赛60mg/m2静滴,d1;奥沙利铂100mg/m2静滴,d1;氟尿嘧啶400mg/m2静滴,d1~d2;氟尿嘧啶600mg/m248h持续泵入d2~d3;3周为1周期;n=24)和FOLFOX 4组(奥沙利铂85mg/m2静滴,d1;亚叶酸钙200mg/m2静滴,d1~d2;氟尿嘧啶400mg/m2静滴,d1~d2;氟尿嘧啶600 mg/m2持续静滴22h;2周为1周期;n=23)。每6周评价疗效。比较两组的有效率(RR)、疾病控制率(DCR)、无进展生存期(PFS)和总生存期(OS)。结果 47例患者均可评价疗效。改良DCF组获PR 6例、SD 16例、PD 2例,RR为25.0%,DCR为91.6%;FOLFOX 4组获PR 2例、SD 16例、PD 5例,RR为8.6%,DCR为78.2%。两组RR和DCR的差异无统计学意义(P>0.05)。改良DCF组的中位PFS为8.2个月,中位OS为11.5个月;FOLFOX 4组的中位PFS为5.8个月,中位OS为10.1个月,两组差异无统计学意义(P>0.05)。两组主要不良反应为骨髓抑制和消化道反应,均以1~2级为主,两组差异无统计学意义(P>0.05)。结论改良DCF方案与FOLFOX 4方案一线治疗晚期胃癌的疗效和不良反应相当,值得临床进一步探索。更多还原

【Abstract】 Objective To evaluate the efficacy and toxicity of modified DCF regimen compared with FOLFOX 4 regimen as the first-line treatment for patients with advanced gastric cancer. Methods Form January 2010 to July 2013,47 advanced gastric carcinoma patients were enrolled in this study. Twenty-four patients received modified DCF regimen( docetaxel 60mg / m2iv,d1; oxaliplatin 100mg / m2iv,d1; fluorouracil 400 mg/m2iv,d1-d2; fluorouracil 600 mg/m2civ 48h,d2-d3; 21 days was a cycle) and 23 patients received FOLFOX 4 regimen( oxaliplatin 85mg / m2iv,d1; calcium folinate 200mg/m2iv,d1-d2; fluorouracil 400mg/m2iv,d1-d2; fluorouracil 600 mg / m2civ 22h; 14 days was a cycle). The efficacy was evaluated every 6 weeks. The response rate( RR),disease control rate( DCR),progression-free survival( PFS) and overall survival( OS) were analyzed between the two groups. Results Efficacy could be evaluated in all patients. Patients in modified DCF group achieved PR in 6 cases,SD in 16 cases and PD in 2 cases with RR of 25. 0% and DCR of 91. 6%. Patients in FOLFOX 4 group achieved PR in 2 cases,SD in 16 cases and PD in 5 cases with RR of 8. 6% and DCR of 78. 2%. The differences of DCR and RR between the two groups had no significance( P>0. 05). Meanwhile,the median PFS and OS were 8. 2 and 11. 5 months in modified DCF group and 5. 8 and 10. 1 months in FOLFOX 4 group with no significant differences( P>0. 05). The main toxicities were myelosuppression and digestive tract reaction,mainly in grade 1-2,and the incidence of the two groups had no differences( P>0. 05). Conclusion There are similar efficacy and toxicities between modified DCF regimen and FOLFOX 4 regimen,which is worth further study.更多还原