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目的探讨多西紫杉醇联合卡培他滨治疗晚期胃癌的效果。方法选取2009年6月至2012年6月间收治的56例晚期胃癌患者,采用随机数字表法分为观察组(TC方案)和对照组(FOLFOX4方案),各28例。观察组患者卡培他滨每天2 000 mg/m2,分早晚两次口服,第1~14天;多西紫杉醇35 mg/m2静脉滴注,第1、8天。每21天为1个周期;对照组患者奥沙利铂130 mg/m2静脉滴注,第1天;亚叶酸钙200 mg/m2,静脉滴注2 h,第1、2天;5-氟尿嘧啶400 mg/m2,静脉推注,第1、2天;5-氟尿嘧啶600 mg/m2,持续泵入22 h,第1、2天,每14天重复,28天为1个周期。每2个周期评价疗效,每周期评价不良反应。结果所有患者均可评价疗效及不良反应。观察组与对照组患者治疗的有效率(分别为50.0%和46.4%)、疾病控制率(分别为82.1%和78.6%)、中位疾病进展时间(分别为5.8个月和5.2个月)、中位总生存期(分别为10.3个月和8.9个月)差异均无统计学意义(均P>0.05)。两组患者血液学及胃肠道反应发生率差异无统计学意义,观察组脱发及手足综合征的发生率高于对照组(P<0.05),对照组周围神经毒性发生率高于观察组(P<0.05)。结论TC方案的治疗效果与FOLFOX4方案一线治疗晚期胃癌的治疗效果无明显差距,不良反应可耐受,值得临床推广。
Objective To investigate the efficacy of docetaxel combined with capecitabine in the treatment of advanced gastric cancer. Methods Fifty-six patients with advanced gastric cancer who were admitted between June 2009 and June 2012 were randomly divided into observation group (TC group) and control group (FOLFOX4 group), 28 cases in each group. In the observation group, capecitabine was administered daily at 2 000 mg / m2, orally twice daily in morning and evening, for days 1 to 14; docetaxel 35 mg / m2 was intravenously administered on days 1 and 8. Every 21 days for one cycle; the control group of patients with oxaliplatin 130 mg / m2 intravenous drip, the first day; leucovorin 200 mg / m2, intravenous infusion of 2 h, day 1,2; 5-fluorouracil 400 mg / m2, intravenous bolus, day 1, 2; 5 - fluorouracil 600 mg / m2, continued to pump 22 h, the first and second days, repeated every 14 days, 28 days for a cycle. Efficacy was evaluated every 2 cycles and adverse reactions were evaluated on a weekly basis. Results All patients can evaluate the efficacy and adverse reactions. The efficacy of treatment (50.0% and 46.4%, respectively) in the observation and control groups, disease control rates (82.1% and 78.6%, respectively) and median disease progression time (5.8 and 5.2 months, respectively) The median overall survival (10.3 and 8.9 months respectively) showed no significant difference (all P> 0.05). There was no significant difference in the incidence of hematology and gastrointestinal reaction between the two groups. The incidence of alopecia and hand-foot syndrome in the observation group was higher than that in the control group (P <0.05), and the incidence of peripheral neurotoxicity in the control group was higher than that in the observation group P <0.05). Conclusion There is no significant difference between the treatment effect of TC regimen and the first-line FOLFOX4 regimen in the treatment of advanced gastric cancer. Adverse reactions are tolerable and worthy of clinical promotion.