CAJ | 학술논문

目的：观察改良 DCF 方案与 XELOX 方案一线治疗晚期胃癌的临床疗效和安全性。方法：收集2010年10至2013年7月收治的65例初治晚期胃癌患者，其中41例应用改良 DCF 方案和24例应用 XELOX 方案。改良 DCF 方案为多西他赛60mg／m2静滴，d1；顺铂15mg／m2静滴，d1～5；氟尿嘧啶375mg／m2静滴，d1～5，21天为1周期。XELOX 方案为奥沙利铂130mg／m2静滴，d1；卡培他滨1250mg／m2，分2次口服，d1～14，21天为1周期。化疗2个周期后按照 RECIST 1．1标准评价疗效，按 NCI CTC 3．0版评价毒副反应并随访生存情况。结果：65例患者均可评价疗效。改良 DCF 方案和 XELOX 方案的有效率（RR）分别为34．1％和33．3％，疾病控制率（DCR）分别为75．6％和70．8％，中位无进展生存期（PFS）分别为7．6个月和7．2个月，中位生存时间（OS）分别为11．9个月和11．5个月，以上差异均无统计学意义（P ＞0．05）。两组不良反应均可耐受，主要表现为骨髓抑制、乏力、消化道反应，以 I －II 级为主，III －IV 级较少；但 DCF 组白细胞下降和乏力发生率高于XELOX 组（P ＜0．05），XELOX 组周围神经毒性和手足综合征发生率高于 DCF 组（P ＜0．05）。结论：改良 DCF方案与 XELOX 方案一线治疗晚期胃癌的疗效相近，毒副反应可耐受，临床上可根据患者年龄、体力状况及其他因素个体化选择化疗方案。
목적：관찰개량 DCF 방안여 XELOX 방안일선치료만기위암적림상료효화안전성。방법：수집2010년10지2013년7월수치적65례초치만기위암환자，기중41례응용개량 DCF 방안화24례응용 XELOX 방안。개량 DCF 방안위다서타새60mg／m2정적，d1；순박15mg／m2정적，d1～5；불뇨밀정375mg／m2정적，d1～5，21천위1주기。XELOX 방안위오사리박130mg／m2정적，d1；잡배타빈1250mg／m2，분2차구복，d1～14，21천위1주기。화료2개주기후안조 RECIST 1．1표준평개료효，안 NCI CTC 3．0판평개독부반응병수방생존정황。결과：65례환자균가평개료효。개량 DCF 방안화 XELOX 방안적유효솔（RR）분별위34．1％화33．3％，질병공제솔（DCR）분별위75．6％화70．8％，중위무진전생존기（PFS）분별위7．6개월화7．2개월，중위생존시간（OS）분별위11．9개월화11．5개월，이상차이균무통계학의의（P ＞0．05）。량조불량반응균가내수，주요표현위골수억제、핍력、소화도반응，이 I －II 급위주，III －IV 급교소；단 DCF 조백세포하강화핍력발생솔고우XELOX 조（P ＜0．05），XELOX 조주위신경독성화수족종합정발생솔고우 DCF 조（P ＜0．05）。결론：개량 DCF방안여 XELOX 방안일선치료만기위암적료효상근，독부반응가내수，림상상가근거환자년령、체력상황급기타인소개체화선택화료방안。
Objective:To evaluate the efficacy and toxicity of modified DCF regimen compared with XELOX regi-men as the first -line treatment for patients with advanced gastric cancer.Methods:Form October 2010 to July 2013,Sixty -five advanced gastric cancer patients without chemotherapy as initial treatment were enrolled.Forty -one pa-tients received modification DCF regimen(docetaxel 60mg/m2 iv,d1 ;cisplatin 15mg/m2 iv d1 ~5 ;flurouracil 375mg/m2 iv d1 ~5 ;21 days was a cycle).Twenty -four patients received XELOX regimen(oxaliplatin 130mg/m2 iv,d1 ;capecit-abine 1250mg/m2 po bid,d1 ~14 .21 days was a cycle).The efficacy and the toxicity were evaluated according to RE-CIST 1.1 criteria and the NCI CTC 3.0 every 2 cycles.The survival status were followed up.Results:Efficacy could be evaluated in all patients.The response rates(RR)were 34.1% and 33.3%,and the disease control rates(DCR) were 75.6% and 70.8% in modified DCF regimen and XELOX regimen group,respectively.The median progression-free survival(PFS)and overall survival(OS)were 7.6 months and 11.9 months in modified DCF regimen group and 7.2 months and 11.5 months in XELOX regimen group with no significant differences (P >0.05).Toxicity of two groups were tolerable.The main toxicities were myelosuppression,fatigue and digestive tract reaction,mainly in grade I -II,and rarely in grade III -IV.The incidence of myelosuppression and fatigue were higher in DCF regimen group than those in XELOX regimen group with significant differences(P <0.05).The incidence of peripheral neu-ropathy and hand -foot syndrome lower in DCF regimen group than those in XELOX regimen group with significant differences(P <0.05).Conclusion:There are similar efficacy and toxicities between modified DCF regimen and XE-LOX regimen as the first -line chemotherapy for patients of advanced gastric cancer.We should choose individual chemotherapy regimens by patients'age,performance status and other factors.