临床肿瘤学杂志

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多西紫杉醇为主的两药联合方案与三药联合方案一线治疗国人晚期胃癌的疗效比较

李慧1,王靖华2,华海清1,秦叔逵1,王琳1,陈映霞1,刘秀峰1
  

  1. 1 1210002 解放军八一医院全军肿瘤中心肿瘤内科 2 210002 南京 南京大学医学院临床学院 南京军区南京总医院肿瘤内科
  • 收稿日期:2013-02-28 修回日期:2013-04-05 出版日期:2013-07-31 发布日期:2013-07-31
  • 通讯作者: 秦叔逵

Comparison of efficacy of docetaxel-containing doublet regimen or triplet regimen as first-line chemotherapy for Chinese patients with advanced gastric cancer

LI Hui,WANG Jinghua,HUA Haiqing,QIN Shukui,WANG Lin,CHEN Yingxia,LIU Xiufeng.
  

  1. Department of Medical Oncology,Nanjing General Hospital of Nanjing Military Command,Clinical College of Medical School of Nanjing University,Nanjing 210002,China
  • Received:2013-02-28 Revised:2013-04-05 Online:2013-07-31 Published:2013-07-31
  • Contact: QIN Shukui

摘要:

目的 分析比较多西紫杉醇(TXT)为主的两药联合方案和三药联合方案一线治疗国人晚期胃癌的有效性与安全性。方法 收集2009年1月至2012年1月收治的46例初治晚期胃癌患者,包括20例应用三药联合的改良DCF方案(三药联合组)和26例应用两药联合的DC或DF方案(两药联合组)。三药联合组具体为:TXT 30mg/m2静滴,d1、d8;顺铂(DDP)20mg静滴,d1~d5;氟尿嘧啶(5-FU)500mg/m2静滴,d1~d5,21天为1周期。两药联合组具体为:TXT 37.5mg/m2静滴,d1、d8;DDP 20mg静滴,d1~d5或5-FU 500mg/m2静滴,d1~d5,21天为1周期。化疗2个周期后按照RECIST 1.0标准评价疗效,按NCI CTC 30版评价毒副反应并随访生存情况。结果 46例患者中有45例可评价客观疗效,46例均可评价不良反应。三药联合组和两药联合组的有效率(RR)分别为31.6%和26.9%,疾病控制率(DCR)分别为68.4%和57.7%,中位肿瘤进展时间(TTP)分别为5.2个月和4.5个月,中位生存时间(OS)分别为10.0个月和9.1个月,以上差异均无统计学意义(P>0.05)。两组不良反应均可耐受,主要为乏力、骨髓抑制、黏膜炎,大多为1~2级,3~4级少见;但两药联合组乏力、骨髓抑制及黏膜炎的发生率均低于三药联合组,差异有统计学意义(P<0.05)。结论 在采用TXT为主的联合方案一线治疗国人晚期胃癌时,两药联合方案与三药联合方案的疗效相当,且两药方案耐受性更好,值得临床重视。

Abstract:

Objective To compare and analyze the efficacy and safety of docetaxelcontaining doublet regimen or triplet regimen as the firstline chemotherapy for Chinese patients with advanced gastric cancer. Methods Forty-six advanced gastric cancer patients without chemotherapy as initial treatment were enrolled from January 2009 to January 2012. Twenty patients received modification DCF regimen(docetaxel 30mg/m2 iv,d1,d8;cisplatin 20mg iv,d1-d5;flurouracil 500mg/m2iv,d1-d5;every 3 weeks was a cycle). Twenty-six patients received double DC/DF regimen(docetaxel 37.5mg/m2 iv,d1,d8;cisplatin 20mg iv or flurouracil 500mg/m2 iv,d1-d5; every 3 weeks was a cycle). The efficacy and the toxicity were evaluated according to RECIST 1.0 criteria and the NCI CTC 3.0 every 2 cycles. The survival status were followed up. Results Forty-five patients could be evaluated efficacy,and 46 patients could be evaluated adverse events. The respose rates(RR) were 31.6% and 26.9%, and the disease control rates(DCR)were 68.4% and 57.7% in triplet regimen and doublet regimen group, respectively. The median time to tumor progression(TTP) were 5.2 months and 4.5 months and the median overall survive(OS) were 10.0 months and 9.1 months,respectively. The above differences were no statistical significance(P>0.05). Toxicity of two groups were tolerable. The major adverse events were grade 1/2 hematologic toxicity,and grade 3/4 were rare. The incidence of bone marrow suppression,catarrh and fatigue were lower in doublet regimen group than those in triple regimen group with significance difference. Conclusion Docetaxelcontaining doublet regimen as the firstline chemotherapy for advanced gastric cancer of Chinese patients has similar efficacy and better tolerance compared to triplet regimen. It deserves further clincal research.

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