【摘要】 目的:观察卡培他滨联合多西紫杉醇与L-OHP+5-FU+LV方案治疗晚期和复发胃癌的临床疗效及毒副反应。方法:治疗组23例采用卡培他滨2500mg/(m2·d),分早晚两次口服,第1～14天;多西紫杉醇75mg/m2,静滴,第1天和第8天。每21d为1个周期,共2～4周期,对照组23例采用L-OHP+5-FU+LV方案:L-OHP130mg/m2静滴,第1天,亚叶酸钙(LV)200mg/m2,静脉推注,第1～5天;氟尿嘧啶(5-FU)500mg/m2,静滴6h,第1～5天。结果:治疗组23例总有效率为63.2%(12/19)。12例初治病例有效率为66.7%(8/12),其中CR2例;7例复治病例有效率为57.1%(4/7),其中CR1例。初治和复治病例的中位缓解期分别为7个月和5.3个月。对照组23例总有效率(CR+PR)为52.9%(9/17),CR1例(5.8%),PR8例(47%),中位缓解期为5.2个月。治疗组血液毒性主要表现为白细胞减少,发生率为68.4%,其中Ⅲ～Ⅳ度白细胞减少26.3%。手足综合征发生率为42.1%;对照组血液毒性轻微,末梢神经炎发生率52.9%。结论:卡培他滨联合多西紫杉醇治疗晚期和复发胃癌有较好的疗效,不良反应较少,是治疗晚期和复发胃癌的有效方案。更多还原

【Abstract】 Objective To evaluate the efficacy and toxicities between xeloda combined with docetaxel and L- OHP+ 5- FU+ LV in the treatment for advanced gastric cancer (AGC). Methods 23 cases of AGC were assigned to the experimental group (EG) and treated with xeloda(1 250 mg/m2, twice a day, 14 days totally) and docetaxel (75 mg/m2, ivdrip, day1and 8). Every 3 weeks was a treatment cycle. Other 23 cases were allocated to the control group (CG) and treated with L- OHP(130 mg/m2 ivdrip, day1)+ 5- FU(500 mg/m2 ivdrip, day 1～ 5)+ LV(200 mg/m2 iv, day 1～ 5). All of the patients received 4 cycles.Results The total response rate in EG was 63.2% (12/19). The response rate of primary treatment was 66.7% (8/12), with two CRs. The response rate of secondary treatment was 57.1% (4/7), with one CR. Median remission of primary and secondary treatment were 7 months and 5.3 months respectively. The overall response rate in CG was 52.9% (9/17), with one CR and eight PRs. In EG,the main hematologic toxicity was myelosupression (68.4% ), including Ⅲ ～ Ⅳ grade neutropenia (26.3% ). 42.1% of the patients developed hand- foot syndrome In CG, the hematologic toxicity was mild and 52.9% of the patients developed peripheral neuritis. Conclusions Xeloda combined with docetaxel was a safe and effective therapy for patients with AGC.更多还原