紫杉醇或奥沙利铂分别联合氟尿嘧啶类药物一线治疗进展期胃癌的疗效分析

Clinical analysis of paclitaxel or oxaliplatin combined with fluorouracil regimens in the treatment of advanced gastric cancer

关键词:  进展期胃癌  紫杉醇  奥沙利铂  氟尿嘧啶类药物  化学治疗

Key words:  advanced gastric carcinoma  paclitaxel  oxaliplatin  fluorouracil  chemotherapy

摘要:

目的　探讨紫杉醇或奥沙利铂分别联合氟尿嘧啶类药物的两种化疗方案一线治疗进展期胃癌的近期疗效、远期疗效及不良反应。　方法　76例晚期胃癌患者分为A、B两组，A组40例，采用紫杉醇联合氟脲嘧类药物的化疗方案；B组36例，采用奥沙利铂联合氟尿嘧啶类药物的化疗方案。两组患者均接受化疗至少2周期，每2周期评判1次疗效。　结果　A组客观有效率、疾病控制率、中位疾病进展时间、中位生存期、1年生存率分别为47.5%、70.0%、7.0个月、14.0个月和30.0%；B组分别为44.4%、72.2%、5.0个月、13.0个月和27.8%。A、B两组间比较，在客观有效率与生存期方面差异无显著性意义(P>0.05)。A组主要不良反应为血液学毒性，B组主要不良反应为外周神经毒性。　结论　以紫杉醇或奥沙利铂分别联合氟尿嘧啶类药物的联合化疗方案治疗进展期胃癌均有较好的近期和远期疗效，两种方案疗效无明显差异，主要不良反应各有特点，但均可耐受，可根据患者个体状况选择应用。

Abstract:

Objective　To compare the efficacy, toxicity and safety of paclitaxel or oxaliplatin combined with fluorouracil regimens in the treatment of patients with advanced gastric cancer．　Methods　Seventy-six patients with advanced gastric carcinoma were divided into 2 groups. Forty patients enrolled in group A were given paclitaxel-fluorouracil regimen and thirty-six patients in group B received oxaliplatin combined with fluorouracil regimen. Each patient received chemotherapy for at least 2 cycles and was evaluated every 2 cycles.　Results　Objective results in the Group A showed: ORR 47.5%, DCR 70.0%, mTTP 7.0 months, mOS 14 months, one-year survival 30.0% and in Group B were: ORR 44.4%, DCR 72.2%, mTTP 5.0 months，mOS 13 months, one-year survival 27.8%. There was no significant difference in ORR，DCR, mTTP, mOS and 1-year survival between two groups (P>0.05). The main toxicity in group A was bone marrow depression, and neurotoxicity in group B.　Conclusion　Both paclitaxel- fluorouracil regimen and oxaliplatin- fluorouracil regimen showed comparable and good efficacy in the treatment of advanced gastric carcinomas. The toxicities caused by the two regimens were mild and tolerable, respectively.