中国老年保健医学
中國老年保健醫學
중국노년보건의학
CHINESE JOURNAL OF GERIATRIC CARE
2013年
6期
9-11,12
,共4页
陆明洁%王建%刘平%束永前
陸明潔%王建%劉平%束永前
륙명길%왕건%류평%속영전
晚期胃癌%药物疗法%紫杉醇脂质体%卡培他滨
晚期胃癌%藥物療法%紫杉醇脂質體%卡培他濱
만기위암%약물요법%자삼순지질체%잡배타빈
advanced gastric carcinoma%drug therapy%paclitaxel liposome%capecitabine
目的：评价紫杉醇脂质体联合卡培他滨治疗34例晚期胃癌临床疗效和毒副反应。方法64例晚期胃癌患者分为对照组30例（多西紫杉醇、顺铂联合5-氟尿嘧啶，DCF方案）和实验组34例（紫杉醇脂质体联合卡培他滨，PC方案）。对照组：多西紫杉醇75mg/m2，d1；顺铂20mg/m2，d1～5；5-氟尿嘧啶350mg/m2，d1～5，21天/周期。实验组：紫杉醇脂质体135mg/m2，d1；卡培他滨2000mg/（m2· d），口服，2次/天，d1～14，21天/周期。结果对照组：总计化疗122周期，平均化疗4.07周期，其中CR 2例，PR 12例，SD 7例，PD 9例，近期有效率（ RR）为46.7％，疾病控制率（ DCR）为70％，中位PFS为6.9个月，中位OS 12.5个月。实验组：总计化疗169周期，平均化疗4.97周期，其中PR14例， SD9例， PD11例， RR 为41.2％，DCR为67.6％，中位PFS为6.2个月，中位OS 12个月。两组的RR、DCR、无进展生存曲线及总生存曲线的差异统计学上无显著性。两组主要的毒副反应均为血液学毒性，对照组和实验组出现Ⅲ～Ⅳ度白细胞减少症的发生率分别为56.7％和17.6％，出现Ⅲ～Ⅳ度贫血的发生率分别为13.3％和2.9％。结论紫杉醇脂质体联合卡培他滨为一线治疗晚期胃癌较好的方案，临床耐受性好，值得进一步推广。
目的：評價紫杉醇脂質體聯閤卡培他濱治療34例晚期胃癌臨床療效和毒副反應。方法64例晚期胃癌患者分為對照組30例（多西紫杉醇、順鉑聯閤5-氟尿嘧啶，DCF方案）和實驗組34例（紫杉醇脂質體聯閤卡培他濱，PC方案）。對照組：多西紫杉醇75mg/m2，d1；順鉑20mg/m2，d1～5；5-氟尿嘧啶350mg/m2，d1～5，21天/週期。實驗組：紫杉醇脂質體135mg/m2，d1；卡培他濱2000mg/（m2· d），口服，2次/天，d1～14，21天/週期。結果對照組：總計化療122週期，平均化療4.07週期，其中CR 2例，PR 12例，SD 7例，PD 9例，近期有效率（ RR）為46.7％，疾病控製率（ DCR）為70％，中位PFS為6.9箇月，中位OS 12.5箇月。實驗組：總計化療169週期，平均化療4.97週期，其中PR14例， SD9例， PD11例， RR 為41.2％，DCR為67.6％，中位PFS為6.2箇月，中位OS 12箇月。兩組的RR、DCR、無進展生存麯線及總生存麯線的差異統計學上無顯著性。兩組主要的毒副反應均為血液學毒性，對照組和實驗組齣現Ⅲ～Ⅳ度白細胞減少癥的髮生率分彆為56.7％和17.6％，齣現Ⅲ～Ⅳ度貧血的髮生率分彆為13.3％和2.9％。結論紫杉醇脂質體聯閤卡培他濱為一線治療晚期胃癌較好的方案，臨床耐受性好，值得進一步推廣。
목적：평개자삼순지질체연합잡배타빈치료34례만기위암림상료효화독부반응。방법64례만기위암환자분위대조조30례（다서자삼순、순박연합5-불뇨밀정，DCF방안）화실험조34례（자삼순지질체연합잡배타빈，PC방안）。대조조：다서자삼순75mg/m2，d1；순박20mg/m2，d1～5；5-불뇨밀정350mg/m2，d1～5，21천/주기。실험조：자삼순지질체135mg/m2，d1；잡배타빈2000mg/（m2· d），구복，2차/천，d1～14，21천/주기。결과대조조：총계화료122주기，평균화료4.07주기，기중CR 2례，PR 12례，SD 7례，PD 9례，근기유효솔（ RR）위46.7％，질병공제솔（ DCR）위70％，중위PFS위6.9개월，중위OS 12.5개월。실험조：총계화료169주기，평균화료4.97주기，기중PR14례， SD9례， PD11례， RR 위41.2％，DCR위67.6％，중위PFS위6.2개월，중위OS 12개월。량조적RR、DCR、무진전생존곡선급총생존곡선적차이통계학상무현저성。량조주요적독부반응균위혈액학독성，대조조화실험조출현Ⅲ～Ⅳ도백세포감소증적발생솔분별위56.7％화17.6％，출현Ⅲ～Ⅳ도빈혈적발생솔분별위13.3％화2.9％。결론자삼순지질체연합잡배타빈위일선치료만기위암교호적방안，림상내수성호，치득진일보추엄。
Objective To evaluate the efficacy and toxic side effects of paclitaxel liposome combined with capecitabine for trea -ting 34 patients with advanced gastric cancer.Methods A total of 64 patients with advanced gastric cancer were enrolled and as-signed to experimental group (paclitaxel liposome combined with capecitabine as PC regimen ,34 cases) and control group (docetax-el,cisplatin and 5-fluorouracil as DCF regimen,30 cases).Control group was treated with DCF regimen:docetaxel 75mg/m2,d1, cisplatin 20mg/m2 ,d1~5 and 5-fluorouracil 350mg/m2 ,d1~5,21d/cycle.Experimental group was given PC regimen:paclitaxel liposome 135mg/m2,d1;capecitabine 2000mg/(m2· d),po,bid,d1~14,21d/cycle.Results Control group:the total chemothera-py time was 122 cycles,averagely 4.07 cycles.Two patients got complete remission (CR),12 partial remission (PR),7 stable dis-ease (SD) and 9 progressive disease (PD).The short -term response rate (RR) was 46.7%,disease control rate (DCR) was 70%,median progression free survival ( mPFS) was 6.9 months and median overall survival ( mOS) was 12.5 months.Experimental group:the total chemotherapy time was 169 cycles,averagely 4.97 cycles.Fourteen patients got PR,9 SD and 11 PD.The short -term RR was 41.2%,DCR was 67.6%,mPFS was 6.2 months and mOS was 12 months.There were no significant differences re-garding RR,DCR,progression -free survival curves and overall survival curves of two groups.The major toxic side effects of two groups are hematologic toxicities.The incidences of leukopenia and anemia at grades Ⅲ~Ⅳin control group and experimental group were 56.7%and 17.6%as well as 13.3%and 2.9%,respectively.Conclusion Paclitaxel liposome combined with capecitabine as the first line chemotherapy for advanced gastric cancer is effective ,tolerable,and recommendable.
