PFC方案和FOLFOX4方案治疗晚期胃癌的疗效及外周血淋巴细胞表型变化对比的临床研究

摘要

目的 探讨紫杉醇(paclitaxe1)联合顺铂(CDDP)及氟尿嘧啶(5-Fu)的治疗方案(简称PFC方案)和奥沙利铂(L-OHP)联合5-Fu和亚叶酸钙(LV)的治疗方案(简称FOLFOX4方案)对晚期胃癌的疗效、不良反应及外周血淋巴细胞表型的变化.方法 入组56例经病理学或细胞学确诊的晚期胃癌患者,PFC方案化疗30例,FOLFOX4方案化疗26例,均于2个疗程后评价疗效,于1个月后确认、对比其疗效和不良反应,并应用流式细胞仪检测CD3+、CD4+、CD8+、CD19+细胞的百分率.结果 PFC方案组和FOLFOX4方案的总有效率分别为56.7%和42.3%,两组比较有明显差异(P＜0.05),两组晚期胃癌患者经PFC方案和FOLFOX4方案化疗后CD4+、CD4+/CD8+较化疗前升高(P＜0.05),CD3+、CD8+、CD19+细胞没有明显变化(P＞0.05).结论 PFC方案在治疗晚期胃癌上比FOLFOX4方案疗效更好,外周血淋巴细胞表型的检测对于晚期胃癌的治疗效果监测有积极意义.%Objective To evaluate the effectiveness and safety of PFC ( paclitaxel + CDDP +5-Fu) and FOLFOX4 ( L-OHP +5-Fu + LV) in treating advanced gastric cancer. Methods Totally 56 pathologically or cytologically confirmed advanced gastric cancer patients were divided into two groups: PFC group ( n = 36) and FOLFOX4 group ( n = 30) . The patients were evaluated after 2 cycles of treatment. The changes in lymphocyte phenotype were detected with flow cytometry.Results The overall response rate was 56. 7％ in PFC group and 42. 3％ in FOLFOX4 group (P ＜ 0. 05). CD4+ and CD4+/CD8 + in both groups increased after chemotherapy, while CD3 + , CD8 + , and CD19+ remained unchanged. Conclusion PFC is superior to FOLFOX4 in treating advanced gastric cancer in terms of hoth effective ness and side effects.