中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
24期
1677-1680
,共4页
周爱萍%李玉升%杨林%宋岩%孙永琨%张雯%崔成旭%依荷巴丽·迟%袁兴华%吕宁%王金万
週愛萍%李玉升%楊林%宋巖%孫永琨%張雯%崔成旭%依荷巴麗·遲%袁興華%呂寧%王金萬
주애평%리옥승%양림%송암%손영곤%장문%최성욱%의하파려·지%원흥화%려저%왕금만
胃肿瘤%抗肿瘤联合化疗方案%多西紫杉醇%铂类%替吉奥
胃腫瘤%抗腫瘤聯閤化療方案%多西紫杉醇%鉑類%替吉奧
위종류%항종류연합화료방안%다서자삼순%박류%체길오
Stomach neoplasms%Antineoplastic combined chemotherapy protocols%Docetsxel%Platinum%S-1
目的 探索多西紫杉醇、替吉奥联合顺铂(DCS方案)或奥沙利铂(DOS方案)治疗晚期胃癌的疗效及其在综合治疗中的作用.方法 共入组初治、经细胞病理学证实的45例晚期胃癌.化疗药物及用法:多西紫杉醇60 mg/m2,d1;替吉奥,前16例患者为每天60 mg/m2,后续患者为80～120mg/d(按体表面积决定),d1～ 14; DCS方案中顺铂30mg/m2,d1,2；DOS方案中,奥沙利铂111～127 mg/m2(中位117 mg/m2),d2;21 d为1周期.结果 43例完成≥1周期DCS或DOS化疗,中位周期数5个(1-8个).42例可评价疗效:部分缓解(PR)28例(66.7％),疾病稳定(SD)9例,疾病进展(PD)5例.32例单纯化疗患者的中位无进展生存(PFS)7.1个月,中位总生存时间尚未达到.最常见的Ⅲ/Ⅳ度不良反应包括中性粒细胞减少46.5％,血小板减少9.3％,呕吐9.3％、恶心7.0％和腹泻4.7％.14例临床根治性切除困难而无远处转移且完成≥2周期DCS/DOS化疗的患者,10例获得手术切除机会,9例(64.3％)R0切除.结论 DCS/DOS治疗晚期胃癌有效率较高,对根治性切除困难但无远处转移的晚期胃癌可起到良好的降期作用,且不良反应可控制.
目的 探索多西紫杉醇、替吉奧聯閤順鉑(DCS方案)或奧沙利鉑(DOS方案)治療晚期胃癌的療效及其在綜閤治療中的作用.方法 共入組初治、經細胞病理學證實的45例晚期胃癌.化療藥物及用法:多西紫杉醇60 mg/m2,d1;替吉奧,前16例患者為每天60 mg/m2,後續患者為80～120mg/d(按體錶麵積決定),d1～ 14; DCS方案中順鉑30mg/m2,d1,2；DOS方案中,奧沙利鉑111～127 mg/m2(中位117 mg/m2),d2;21 d為1週期.結果 43例完成≥1週期DCS或DOS化療,中位週期數5箇(1-8箇).42例可評價療效:部分緩解(PR)28例(66.7％),疾病穩定(SD)9例,疾病進展(PD)5例.32例單純化療患者的中位無進展生存(PFS)7.1箇月,中位總生存時間尚未達到.最常見的Ⅲ/Ⅳ度不良反應包括中性粒細胞減少46.5％,血小闆減少9.3％,嘔吐9.3％、噁心7.0％和腹瀉4.7％.14例臨床根治性切除睏難而無遠處轉移且完成≥2週期DCS/DOS化療的患者,10例穫得手術切除機會,9例(64.3％)R0切除.結論 DCS/DOS治療晚期胃癌有效率較高,對根治性切除睏難但無遠處轉移的晚期胃癌可起到良好的降期作用,且不良反應可控製.
목적 탐색다서자삼순、체길오연합순박(DCS방안)혹오사리박(DOS방안)치료만기위암적료효급기재종합치료중적작용.방법 공입조초치、경세포병이학증실적45례만기위암.화료약물급용법:다서자삼순60 mg/m2,d1;체길오,전16례환자위매천60 mg/m2,후속환자위80～120mg/d(안체표면적결정),d1～ 14; DCS방안중순박30mg/m2,d1,2；DOS방안중,오사리박111～127 mg/m2(중위117 mg/m2),d2;21 d위1주기.결과 43례완성≥1주기DCS혹DOS화료,중위주기수5개(1-8개).42례가평개료효:부분완해(PR)28례(66.7％),질병은정(SD)9례,질병진전(PD)5례.32례단순화료환자적중위무진전생존(PFS)7.1개월,중위총생존시간상미체도.최상견적Ⅲ/Ⅳ도불량반응포괄중성립세포감소46.5％,혈소판감소9.3％,구토9.3％、악심7.0％화복사4.7％.14례림상근치성절제곤난이무원처전이차완성≥2주기DCS/DOS화료적환자,10례획득수술절제궤회,9례(64.3％)R0절제.결론 DCS/DOS치료만기위암유효솔교고,대근치성절제곤난단무원처전이적만기위암가기도량호적강기작용,차불량반응가공제.
Objective To evaluate the efficacy and safety profile and to explore the role of docetaxel,S-1 plus cisplatin (DCS) or oxaliplatin (DOS) in the treatment of advanced gastric cancer.Methods A total of 45 patients with advanced gastric cancer were recruited.They received DCS or DOS at the discretion of investigators.Docetaxel was given intravenously at the dose of 60 mg/m2 at d1,S-1 60 mg· m-2 ·d-1 or 80 - 120 mg/d according to individual patient's area of body surface orally from d1 to d14 and cisplatin 30 mg/m2 at d1,d2 or oxaliplatin 111 - 127 ( median:117) mg/m2 at d2.Each cycle was for 21 days.Results Forty-three patients received ≥ 1 complete cycle of DCS/DOS with a median cycle number of 5 ( range:1 - 8 ).Among 42 patients evaluated for efficacy,the outcomes were partial response (n =28),stable disease(n =9) and progression(n =5).The response rate was 66.7％.Progression-free survival(PFS) of 32 patients on chemotherapy alone was 7.1 months and the median overall survival (OS) was not reached. The most common grade 3/4 adverse effects included neutropenia (46.5％),thrombocytopenia ( 9.3％ ),vomiting ( 9.3％ ),nausea ( 7.0％ ) and diarrhea ( 4.7％ ).Ten of fourteen patients with advanced unresectable gastric cancer without clinically detectable distant metastases underwent surgical resection after a median of 4 ( 2 - 6 ) cycles of DCS or DOS and 9 ( 64.3％ ) had R0 resection.Conclusions DCS/DOS is effective for advanced gastric cancer and in the setting of neoadjuvant chemotherapy.And the toxicities of DCS/DOS are manageable.
