紫杉醇联合顺铂及卡培他滨治疗晚期胃癌

目的探讨紫杉醇联合顺铂及卡培他滨一线治疗晚期胃癌的疗效和安全性。方法回顾性分析2004年6月-2008年6月收治的使用PCX方案化疗的32例晚期胃癌患者的临床资料。化疗方案：紫杉醇（PTX）150mg／m^2，静脉滴注2h，第1天；顺铂（DDP）25mg／m^2，静脉滴注，第1—3天；卡培他滨1250mg／m^2，口服，第1—14天。21d为1周期，用药至少2个周期后进行疗效评价。结果32例患者均可评价疗效，完全缓解1例，部分缓解12例，稳定13例，进展6例，总有效率40．6％；中位疾病进展时间（TTP）6．1个月（2～14个月），中位生存时问（MST）11个月（2-31个月）。主要不良反应为胃肠道反应和骨髓抑制，多为Ⅰ或Ⅱ度。Ⅲ／Ⅳ度不良反应主要有恶心、呕吐（21．9％，7／32）、中性粒细胞减少（15．6％，5／32）和乏力（9．4％，3／32）。12．5％（4／32）的患者出现中性粒细胞减少性发热。所有患者均无化疗相关性死亡。结论紫杉醇联合顺铂及卡培他滨一线治疗晚期胃癌有较好的疗效，不良反应可以耐受。

Observation Study on Paclitaxel Plus Cisplatin and Capecitabine Regimen as First-line Therapy for Patients with Advanced Gastric Cancer

Objective To evaluate the efficacy and toxicity of paclitaxel plus cispltin and capecitabine regimen as first-line therapy for patients with advanced gastric cancer. Methods From June 2004 to June 2008, thirty-two advanced gastric cancer patients who received PCX regimen were analyzed retrospectively. The combination chemotherapy included paclitaxel 150 mg/m^2 as 2 hours infusion on day 1, cisplatin 25 mg/m^2 on days 1 to 3 and oral capecitabine 1 250 mg/（m^2 ·d） on days 1 to 14. The therapy repeated every 3 weeks. At least two cycles evaluated efficacy. Results Thirty-two patients were assessable for efficacy and toxicity. One patient achieved a complete response and 12 patients had partial responses, with an overall response rate of 40. 6%. The median TTP for all was 6. 1 months （range 2- 14 months）. The median overall survival was 11 months （range 2-31 months）. The most common adverse effects were myelosuppression and gastrointestinal response. Frequent grade Ⅲ/Ⅳ toxicity for PCX were： nausea 21.9%（7/32）, neutropenia 15.6% （5/32） and fatigue 9.4 %（3/32）. Febrile neutropenia occurred 12.5%（4/32）. There was no chemotherapy-related death. Conclusion The combination of paclitaxel plus cispltin and capecitabine is effective and well tolerated as first-line therapy for patients with advanced gastric cancer.