周剂量紫杉醇联合低剂量5-FU持续输注二线治疗晚期胃癌

Clinical study of weekly paclitaxel combined with continuous infusion of low-dose 5-FU as second-line chemotherapy for advanced gastric cancer

关键词:  晚期胃癌  紫杉醇  5-FU  DDP  二线治疗

Key words:  advanced gastric cancer  poulitaxel  5-FU, DDP  second-line chemotherapy

摘要:

［目的］探讨周剂量紫杉醇联合低剂量5-氟尿嘧啶（5-FU）持续输注二线治疗晚期胃癌的疗效和毒性反应。［方法］经病理确诊的晚期胃癌20例，均为一线治疗后失败或复发者，应用PTX 60 mg/m²，d1、8、15，静脉滴注3 h；5-FU 300 mg/d，便携式微量泵持续24 h静脉滴注，连续14 d；DDP 5 mg/d，第1~5天,第7~12天，静脉滴注，21~28 d为1周期，中位化疗周期为3周期，共完成64周期化疗。［结果］20例患者均可评价疗效，CR 1例，PR 7例，SD 5例，PD 7例，RR 40%，TCR 65%；中位无进展时间5个月（3~24个月），中位生存时间8个月（5~30个月）。化疗相关毒性反应主要为骨髓毒性、恶心呕吐、脱发、口腔黏膜炎和神经毒性。［结论］周剂量紫杉醇联合低剂量5-FU持续输注二线治疗晚期胃癌疗效较好，毒性反应轻微，患者能够耐受，值得在临床中进一步研究使用。

Abstract:

［Objective］To investigate the efficacy and the toxicity of weekly paclitaxel combined with continuous infusion of low-dose 5-FU as second-line chemotherapy for advanced gastric cancer.［Methods］A total of 20 patients with metastatic or unresectable gastric adenocarcinoma who had measurable lesions and had disease progression with the front-line chemotherapy were treated with the following regimen, administered every 21~28 days, paclitaxel 60 mg/m² by i.v on d 1,8,15,5-FU 300 mg/d by 24 hours c.i.v for 14 days and cisplatin 5 mg/d by i.v on d 1~5,d 7~12. All the patients received 2~7 cycles of chemotherapy，median 3 cycles.［Results］The overall response rate (CR+PR)was 40%. TCR(CR+PR+SD) was 65%. The median TIP was 5 months(3~24 months). The MST was 8 months(5~30 months). The major toxicity of this treatment were myelosuppression, nausea/vomiting,trichomadesis, mucositis and neurotoxicity.［Conclusions］Weekly paclitaxel combined with continuous infusion of low-dose 5-FU as second-line chemotherapy for advanced gastric cancer is effective and tolerable. It is worth studying in the future.