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目的观察多西他赛联合奥沙利铂治疗晚期胃癌的有效性和安全性。方法将肿瘤内科2008年1月-2011年1月收治的60例晚期胃癌患者随机分为2组。治疗组30例,给予多西他赛75 mg/m2静脉滴注,第1天用药;奥沙利铂130 mg/m2静脉滴注,第4天用药;21 d为1个周期。对照组30例,给予多西他赛75 mg/m2静脉滴注,第1天用药,顺铂75 mg/m2静脉滴注,第1天用药;亚叶酸钙200 mg/m2静脉输注2 h,第1~2天用药;后氟尿嘧啶400 mg/m2静脉推注10 min及氟尿嘧啶600 mg/m2持续静脉泵入22 h,第1~2天用药,21 d为1个周期。所有患者至少接受2个周期化学疗法(化疗)。观察两组的有效率、不良反应、中位生存期及生活质量的改善。结果治疗组与对照组有效率分别为60.0%、46.7%,差异无统计学意义(P>0.05);治疗组食欲增加率(治疗组70.0%、对照组43.3%)、体质量增加率(治疗组60.0%、对照组33.3%)及Karnofsky评分好转率(治疗组63.3%、对照组30.0%)均优于对照组,两组比较差异有统计学意义(P<0.05)。治疗组不良反应较轻,大部分为Ⅰ~Ⅱ度,优于对照组。治疗组与对照组中位疾病进展时间分别为5.8、5.6个月,中位生存期分别为11.8、9.2个月,较对照组延长。结论多西他赛联合奥沙利铂治疗晚期胃癌疗效确切,不良反应轻,患者耐受性好,生活质量明显提高,中位生存期延长,值得临床推广。
Objective To observe the efficacy and safety of docetaxel plus oxaliplatin in the treatment of advanced gastric cancer. Methods Sixty patients with advanced gastric cancer admitted to Department of Oncology from January 2008 to January 2011 were randomly divided into two groups. The treatment group, 30 cases, given docetaxel 75 mg / m2 intravenous drip, the first day of medication; oxaliplatin 130 mg / m2 intravenous infusion, the fourth day of medication; 21 d for a cycle. Control group, 30 patients were given docetaxel 75 mg / m2 intravenous drip, the first day of medication, cisplatin 75 mg / m2 intravenous infusion, the first day of medication; leucovorin 200 mg / m2 intravenous infusion of 2 h , The first to the second days of medication; fluorouracil 400 mg / m2 intravenous injection of 10 min and fluorouracil 600 mg / m2 continuous intravenous infusion of 22 h, 1 to 2 days medication, 21 d for a cycle. All patients received at least 2 cycles of chemotherapy (chemotherapy). The two groups were observed the efficiency, adverse reactions, median survival and quality of life improvement. Results The effective rates of the treatment group and the control group were 60.0% and 46.7%, respectively, with no significant difference (P> 0.05). The appetite increase rate (70.0% in the treatment group and 43.3% in the control group) and the rate of weight gain 60.0% in the control group and 33.3% in the control group), and Karnofsky score improvement rate (63.3% in the treatment group and 30.0% in the control group) were superior to those in the control group. There was significant difference between the two groups (P <0.05). Adverse reactions in the treatment group were mild, mostly Ⅰ ~ Ⅱ degrees, better than the control group. The progression time of median disease in treatment group and control group were 5.8 and 5.6 months respectively, and the median survival time was 11.8 and 9.2 months respectively, which was longer than that in control group. Conclusion Docetaxel combined with oxaliplatin in the treatment of advanced gastric cancer has definite curative effect, mild adverse reactions, good patient tolerance, markedly improved quality of life, and prolonged median survival. It is worthy of clinical promotion.