CAJ | 학술논문

背景与目的：已有研究证实，多西他赛联合顺铂(docetaxel plus cisplatin，DP)或多西他赛联合奥沙利铂(docetaxel plus oxaliplatin，DO)治疗晚期胃癌具有较好的疗效。本研究旨在观察周剂量多西他赛联合顺铂与周剂量多西他赛联合奥沙利铂一线治疗晚期胃癌的疗效及不良反应。方法：76例胃癌患者随机分为两组，每组38例，DP组多西他赛35 mg/m2，静脉滴注，第1、8天，顺铂60 mg/m2，静脉滴注，第1天，21 d为1个周期；DO组多西他赛35 mg/m2，静脉滴注，第1、8天，奥沙利铂120 mg/m2，静脉滴注，第1天，21 d为1个周期。结果：DP组总有效率为37%，中位无进展生存期为4.9个月，中位生存期为9.7个月；DO组总有效率为41%，中位无进展生存期为4.4个月，中位生存期为12.3个月。两组的总有效率(P=0.707)、中位无进展生存期(P=0.324)、中位生存期(P=0.581)差异均无统计学意义。两组的3/4级不良反应都是中性粒细胞减少，DP组恶心、呕吐发生率较高(P<0.05)，而DO组周围神经病变发生率较高(P<0.05)；两组贫血、血小板减少、脱发、腹泻和肝功能损害等不良反应差异均无统计学意义(P>0.05)。结论：DP和DO一线治疗晚期胃癌的疗效及不良反应相仿，值得临床进一步研究。
배경여목적：이유연구증실，다서타새연합순박(docetaxel plus cisplatin，DP)혹다서타새연합오사리박(docetaxel plus oxaliplatin，DO)치료만기위암구유교호적료효。본연구지재관찰주제량다서타새연합순박여주제량다서타새연합오사리박일선치료만기위암적료효급불량반응。방법：76례위암환자수궤분위량조，매조38례，DP조다서타새35 mg/m2，정맥적주，제1、8천，순박60 mg/m2，정맥적주，제1천，21 d위1개주기；DO조다서타새35 mg/m2，정맥적주，제1、8천，오사리박120 mg/m2，정맥적주，제1천，21 d위1개주기。결과：DP조총유효솔위37%，중위무진전생존기위4.9개월，중위생존기위9.7개월；DO조총유효솔위41%，중위무진전생존기위4.4개월，중위생존기위12.3개월。량조적총유효솔(P=0.707)、중위무진전생존기(P=0.324)、중위생존기(P=0.581)차이균무통계학의의。량조적3/4급불량반응도시중성립세포감소，DP조악심、구토발생솔교고(P<0.05)，이DO조주위신경병변발생솔교고(P<0.05)；량조빈혈、혈소판감소、탈발、복사화간공능손해등불량반응차이균무통계학의의(P>0.05)。결론：DP화DO일선치료만기위암적료효급불량반응상방，치득림상진일보연구。
Background and purpose:It has confirmed that docetaxel, in combination with cisplatin or oxaliplatin have good effect in the treatment of advanced gastric cancer. This study in order to observe the clinical efficacy and adverse reaction of weekly docetaxel combined with cisplatin (DP) versus weekly docetaxel combined with oxaliplatin (DO) as the firrst-line treatment of advanced gastric cancer.Methods:A total number of 76 cases of advanced gastric cancer were randomly assigned 2 arms, 38 per arm. DP regimen group (docetaxel 35 mg/m2,ivgtt,dl,d8 combined with cisplatin 60 mg/m2, ivgtt,dl,repeated every 3 weeks) and DO regimen group(docetaxel 35 mg/m2,ivgtt,dl,d8 combined with oxaliplatin 120 mg/m2 ivgtt,dl,repeated every 3 weeks). Results:No significant difference was found between DP regimen group and DO regimen group on the objective RR(37%vs 41%),PFS (4.9vs 4.4 months) and OS (9.7vs 12.3 months). The main grade 3 or 4 toxicity in the DP and DO groups was neutropenia, DO was less associated with nausea and vomiting, but more associated with peripheral neuropathy than DP group. No signiifcant difference was found between DP regimen group and DO regimen group on the anemia, thrombocytopenia, diarrhea, alopecia (P>0.05).Conclusion:Weekly docetaxel combined with cisplatin (DP) shows similar efifcacy and toxicity compared with weekly docetaxel combined with oxaliplatin (DO) as the ifrst-line treatment of advanced gastric cancer and worthy of further study.