目的 研究DOX每周给药方案治疗晚期胃癌的临床疗效和不良反应.方法 2007年6月-2009年6月本院33例晚期胃癌患者采用DOX每周给药方案:多西他赛(Docetaxel)30 mg/m2,加入生理盐水250 ml,静脉滴注1 h,d1,d8;奥沙利铂(L-OHP)60 mg/m2,加入5%葡萄糖注射液250ml,静脉滴注2 h,d1,d8;希罗达(Xeloda)2000mg/m2,连用14d,21 d为1周期,每2周期为1个疗程.治疗2周期后评价近期疗效和毒副反应,无进展生存时间(PFS)和总生存时间(OS).结果 33例患者完全缓解(CR)2例(6%),部分缓解(PR)16例(48.5%),稳定(SD)12例(36.4%),进展(PD)3例(9%);总有效率(RR)54.5%,其中初治RR65%,复治RR 38.5%;疾病控制率(DCR)90.9%,其中初治DCR95%,复治DCR84.6%;全组中位无进展生存期(mPFS)为6.9个月,中位生存期(mOS)为12.1个月.毒性反应主要为骨髓抑制、神经系统毒性、乏力、消化道反应及手足综合征等.结论 DOX每周给药方案治疗晚期胃癌疗效确切,不良反应可控,患者耐受性尚可,值得临床推广应用.%Objective To explore the efficacy and adverse reactions of weekly administration of docetaxel combined with oxalipclation and xeloda in the treatment of advanced gastric cancer. Methods 33 patients with advanced gastric cancer who had been hospitalized from June 2007 to June 2009 received weekly DOX regimen:intravenous infusions of docetaxel of 30mg/m2 with normal saline of 250ml at 1 h and days 1 and 8, Oxaliplat in of 60mg/m2 plus 5% glucose solution of 250ml at 2h and days 1 and 8, and Xeloda of 2000mg/m2 for 14 days, 21 days for a cycle and 2 cycles for a course. The short-term efficacy, toxicity reactions, progression-free survival, and overall survival were assessed 2 weeks after treatment. Results Of 33 patients, 2 patients ( 6% ) had complete remission ( CR ), 16 (48.5% ) partial remission ( PR ), 12 ( 36.4% ) stable disease ( SD ), and 3 (9% ) progressive disease ( PD ). The total efficacy was 54.5%, 65% in primary treatment and 38.5% in repeat treatment; the disease control rate ( DCR ) was 90.9%, 95% in primary treatment and 84.6% in repeat treatment. The median progression-free survival Period ( mPFS ) was 6.9 months, median overall survival ( mOS ) was 12.1 months. The main toxicity reactions were myelosuppression, neurological toxicity, fatigue, gastrointestinal reactions, and hand-foot syndrome. Conclusions Weekly administration of DOX for advanced gastric cancer is effective and had controllable adverse reactions and ideal tolerance, thus is worth popularizing.
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