胃癌术后多西他赛联合顺铂序贯S-1方案辅助化疗的疗效观察

目的 探讨胃癌术后ⅢB～ⅢC期患者应用多西他赛联合顺铂6个周期后序贯S-1方案辅助化疗的临床疗效和安全性。方法 回顾性分析2011年4月至2012年10月胃癌D2根治术后ⅢB～ⅢC期患者32例，术后4周开始接受辅助化疗。具体方案为：多西他赛75 mg／m2静滴，d1；顺铂25 mg／m2静滴，d1～d3，21天为1周期，化疗6个周期；序贯S-1 80 mg／m2，分两次口服，d1～d14，21天为1周期，口服至术后1年。观察全组患者的3年生存率、3年无复发生存率及不良反应。结果 所有患者均按计划完成化疗。术后1、2、3年生存率分别为90.6％、81.2％、65.0％，1、2、3年无复发生存率分别为90.6％、81.2％、50.4％。术后辅助化疗的疗效与病理分期无关（P＞0.05），而与淋巴结转移数目有关，淋巴结转移数目≤3枚者的3年生存率优于＞3枚者（78.6% vs. 54.2%，P＜0.05）。化疗不良反应包括骨髓抑制、消化道反应及脱发等，以1～2级为主。结论 对于有高危因素的胃癌术后患者给予多西他赛联合顺铂方案化疗6个周期后序贯S 1单药口服至术后1年的辅助化疗，术后生存率及无复发率相对较高，且安全性良好，是安全有效的术后辅助化疗方案。

Clinical efficacy of docetaxel plus cisplatin sequentially combined with S-1 as adjuvant chemotherapy for gastric cancer after operation

Objective To evaluate the clinical efficacy and safety of docetaxel plus cisplatin sequentially combined S-1 for patients with gastric cancer of ⅢB-ⅢC stage after operation. Methods A total of 32 patients with gastric cancer of ⅢB-ⅢC stage treated with adjuvant chemotherapy 4 weeks after D2 radical resection were analyzed retrospectively. The adjuvant chemotherapy regimen was as follows：docetaxel 75mg／m2 iv d1；cisplatin 25mg／m2 iv d1-d3. Six cycles were applied with 21 days as a cycle. Then S-1 was orally given as follows：80 mg／m2 for 2 times daily from d1-d14 and 21 days were a cycle. S-1 was applied to 1 year after operation. Patients' 3-year survival，3-year recurrence-free survival and adverse reactions were observed. Results All the patients accomplished chemotherapy in plan. The 1-，2-and 3-year survival rate of 32 patients was 90.6％，81.2％ and 65.0％，respectively. The 1-，2-and 3-year recurrence-free survival rate was 90.6％，81.2％ and 50.4％，respectively. The clinical efficacy was not associated with pathological stage，but with number of lymph nodes（P＜0.05）. Patients bearing metastatic lymph nodes three or less had better 3-year survival rate compared with those bearing lymph node more than 3（78.6％ vs. 54.2％, P＜0.05）. Adverse reactions included bone marrow suppression，gastrointestinal symptoms and hair loss，mainly in grade 1-2. Conclusion Docetaxel plus cisplatin sequentially combined with S-1 as adjuvant chemotherapy for gastric patients with high risk can bring better overall survival, recurrence-free survival，and adverse effect are well-tolerated.