周剂量多西他赛联合顺铂及低剂量5-氟尿嘧啶治疗晚期胃癌的临床观察

目的 评价周剂量多西他赛联合顺铂及低剂量5-氟尿嘧啶治疗晚期胃癌的临床疗效和安全性.方法 42例晚期胃癌患者随机分入试验组和对照组,各21例,试验组:第1、8、15天予多西他赛35mg/m2静滴1小时;5-氟尿嘧啶250mg/m2持续静脉输注,连用15天;顺铂25mg/m2静滴第1～3天,每28天为一疗程.对照组:第1天予多西他赛75mg/m2静滴1小时,顺铂75mg/m2静滴;5-氟尿嘧啶750mg/m2自第1天起持续静脉输注,连用5天,每21天为一疗程.结果 42例均评价疗效,其中试验组完全缓解1例,部分缓解12例,总有效率为61.90%.对照组完全缓解1例,部分缓解11例,总有效率57.14%.两组对比无显著差异.主要不良反应为白细胞减少,其中Ⅲ-Ⅳ度白细胞减少,试验组为28.57%,对照组为61.90%;恶心、呕吐发生率,试验组为38.09%,对照组为71.43%,两组差异显著(P＜0.05).两组腹泻发生率分别为42.86%和28.57%,但未见组间显著差异(P＞0.05).结论 周剂量多西他赛联合顺铂及低剂量5-氟尿嘧啶治疗晚期胃癌具较高的临床缓解率,毒副反应较轻,值得临床推广.

Study of Docetaxel Combinating with Cisplatin and Low-Dose 5-Fluorouracil in the Treatment of Advanced Gastric Carcinoma

Objective To evaluate the efficacy and safety of weekly dose docetaxel(DOC) combined with cisplatin (DDP) and low-dose 5-fluorouracil(5-FU)in the treatment of advanced gastric carcinoma. Methods 42 patients were randomly divided into 2 groups, the test group(n=21) and the control group(n=21). The test group was administrated DOC 35mg/m2 intravenously guttae on days1, 8and 15, DDP 25mg/m2 intravenously guttae on days 1-3 and 5-FU 250mg/m2 intravenously once daily for 15 days. Cycles was 28 days. The control group was administrated DOC 75mg/m2 and DDP 75mg/m2 intravenously guttae on the first day and 5-FU 750mg/m2 intravenously guttae once daily for 5 days. Cycles was 21 days. Result There were no significant differences in the total effective rate between two groups (61.9% vs 57.14%, P>0.05). The incidence rates of hypolekocytosis, nausea and emesis in the test group were lower than these of the control group, significantly (P<0.05). There was no significant difference in the incidence rate of diarrhea between two groups (P>0.05). Conclusion Weekly dose docetaxel (DOC) combinating with cisplatin (DDP) and low-dose 5-fluorouracil (5-FU) can be used effectively and safely in the treatment of advanced gastric carcinoma.