胃癌患者中改良 DCF 化疗两周方案与三周方案疗效及毒副反应的比较观察

摘要

目的：比较改良的多西他赛联合顺铂和氟尿嘧啶（DCF）化疗的两周方案与三周方案的疗效及毒副反应。方法入组的56例晚期胃癌患者按照随机原则分为 A 组、B 组，A 组给予改良 DCF 两周方案化疗，B组给予改良 DCF 三周方案化疗，比较观察两者的疗效及毒副反应。结果 A 组28例晚期胃癌患者平均化疗4.5周期，疗效评价结果显示总有效率为39.3％，疾病控制率为85.7％，毒副反应主要为消化道反应，发生率为71.4％，白细胞减少、中性粒细胞减少、神经毒性、皮肤黏膜反应、肝肾功能损伤发生率分别为67.9％、64.3％、42.9％、32.1％、35.7％，大多为Ⅰ、Ⅱ度。B 组28例晚期胃癌患者平均化疗4.5周期，其中1例因骨髓抑制反应过重停止应用此方案化疗，疗效评价结果显示总有效率为33.3％，疾病控制率为81.5％，毒副反应主要为消化道反应，发生率为100.0％，白细胞减少、中性粒细胞减少、神经毒性、皮肤黏膜反应、肝肾功能损伤发生率分别为85.7％、75.0％、57.1％、39.3％、39.3％，大多为Ⅰ、Ⅱ度。2组均无严重感染、出血等治疗相关死亡发生。结论2种方案近期疗效相近，但三周方案毒副反应较重。%Objective To compare the differences of the modified docetaxel combined with cisplatin and fluorou-racil(DCF)regimen between two weeks’and three weeks’regimen in the curative effect and toxicities. Methods Fifty-six patients with advanced gastric cancer were divided into group A and B according to the random princi-ple. Group A were treated with modified DCF two weeks’chemotherapy regimen,group B were treated with the mod-ified DCF three week’chemotherapy regimen,and the curative effect and toxicities were compared. Results In group A,28 patients with advanced gastric cancer were treated with chemotherapy for 4. 5 cycles,the total effective rate was 39. 3% ,the disease control rate was 85. 7% ,the main toxicity was gastrointestinal reaction(71. 4% ),the white blood cells decreased,neutrophils decreased,gastrointestinal reactions,neurotoxicity,skin and mucous mem-brane damage,liver and kidney function damage rates were 67. 9% ,64. 3% ,42. 9% ,32. 1% ,35. 7% . In group B, 28 patients with advanced gastric cancer were treated with chemotherapy for 4. 5 cycles,the total effective rate was 33. 3% ,the disease control rate was 81. 5% ,the main toxicity was gastrointestinal reaction(100. 0% ),the white blood cells decreased,neutrophils decreased,gastrointestinal reactions,neurotoxicity,skin and mucous membrane damage,liver and kidney function damage rates were 85. 7% ,75. 0% ,57. 1% ,39. 3% ,39. 3% . Two groups were no serious infection,bleeding and other treatment related death. Conclusion There is no significant difference be-tween the two regimens in the curative effect,and the toxicities of the three weeks’regimen are more significant.