临床肿瘤学杂志

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胃癌术后多西他赛联合顺铂序贯S-1方案辅助化疗的疗效观察

250031 济南 山东省医学科学院附属医院内五科   

  1. 250031 济南 山东省医学科学院附属医院内五科
  • 收稿日期:2016-05-16 修回日期:2016-07-12 出版日期:2016-08-31 发布日期:2016-08-31
  • 通讯作者: 盛立军

Clinical efficacy of docetaxel plus cisplatin sequentially combined with S-1 as adjuvant chemotherapy for gastric cancer after operation

AN Yuji,SHENG Lijun,SONG Pengyuan,ZHANG Zhen,PANG Min,HE Weina,ZHANG Weihua   

  1. The Fifth Department of Oncology,Affiliated Hospital of Shandong Academy of Medical Sciences,Jinan 250031,China
  • Received:2016-05-16 Revised:2016-07-12 Online:2016-08-31 Published:2016-08-31
  • Contact: SHENG Lijun

摘要: 目的 探讨胃癌术后ⅢB~ⅢC期患者应用多西他赛联合顺铂6个周期后序贯S-1方案辅助化疗的临床疗效和安全性。方法 回顾性分析2011年4月至2012年10月胃癌D2根治术后ⅢB~ⅢC期患者32例,术后4周开始接受辅助化疗。具体方案为:多西他赛75 mg/m2静滴,d1;顺铂25 mg/m2静滴,d1~d3,21天为1周期,化疗6个周期;序贯S-1 80 mg/m2,分两次口服,d1~d14,21天为1周期,口服至术后1年。观察全组患者的3年生存率、3年无复发生存率及不良反应。结果 所有患者均按计划完成化疗。术后1、2、3年生存率分别为90.6%、81.2%、65.0%,1、2、3年无复发生存率分别为90.6%、81.2%、50.4%。术后辅助化疗的疗效与病理分期无关(P>0.05),而与淋巴结转移数目有关,淋巴结转移数目≤3枚者的3年生存率优于>3枚者(78.6% vs. 54.2%,P<0.05)。化疗不良反应包括骨髓抑制、消化道反应及脱发等,以1~2级为主。结论 对于有高危因素的胃癌术后患者给予多西他赛联合顺铂方案化疗6个周期后序贯S1单药口服至术后1年的辅助化疗,术后生存率及无复发率相对较高,且安全性良好,是安全有效的术后辅助化疗方案。

Abstract: Objective To evaluate the clinical efficacy and safety of docetaxel plus cisplatin sequentially combined S-1 for patients with gastric cancer of ⅢB-ⅢC stage after operation. Methods A total of 32 patients with gastric cancer of ⅢB-ⅢC stage treated with adjuvant chemotherapy 4 weeks after D2 radical resection were analyzed retrospectively. The adjuvant chemotherapy regimen was as follows:docetaxel 75mg/m2 iv d1;cisplatin 25mg/m2 iv d1-d3. Six cycles were applied with 21 days as a cycle. Then S-1 was orally given as follows:80 mg/m2 for 2 times daily from d1-d14 and 21 days were a cycle. S-1 was applied to 1 year after operation. Patients' 3-year survival,3-year recurrence-free survival and adverse reactions were observed. Results All the patients accomplished chemotherapy in plan. The 1-,2-and 3-year survival rate of 32 patients was 90.6%,81.2% and 65.0%,respectively. The 1-,2-and 3-year recurrence-free survival rate was 90.6%,81.2% and 50.4%,respectively. The clinical efficacy was not associated with pathological stage,but with number of lymph nodes(P<0.05). Patients bearing metastatic lymph nodes three or less had better 3-year survival rate compared with those bearing lymph node more than 3(78.6% vs. 54.2%, P<0.05). Adverse reactions included bone marrow suppression,gastrointestinal symptoms and hair loss,mainly in grade 1-2. Conclusion Docetaxel plus cisplatin sequentially combined with S-1 as adjuvant chemotherapy for gastric patients with high risk can bring better overall survival, recurrence-free survival,and adverse effect are well-tolerated.

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