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目的观察紫杉醇脂质体联合顺铂、氟尿嘧啶治疗晚期胃癌的临床疗效和毒性反应。方法 37例晚期胃癌患者予紫杉醇脂质体135mg/m2,静滴3h,d1;顺铂20mg/m2,静滴d1～4;亚叶酸钙200mg/m2,静滴2h,d1～5;氟尿嘧啶750mg/m2,静滴4～6h d1～5。21d为l周期,每例患者至少治疗2个周期。结果 37例患者中完全缓解(CR)2例(5.4%),部分缓解(PR)16例(43.2%),稳定(SD)11例(29.7%),进展(PD)8例(21.6%),总有效率(CR+PR)48.6%(18/37)。临床获益率78.4%,中位TTP5.8个月,中位生存时间10.6个月。毒副反应主要为骨髓抑制、消化道反应、疲乏和脱发。全组病例无治疗相关性死亡。结论紫杉醇脂质体联合顺铂、氟尿嘧啶治疗晚期胃癌疗效肯定、毒性反应轻、耐受性好。
Objective To observe the clinical efficacy and toxicity of paclitaxel liposome combined with cisplatin and fluorouracil in the treatment of advanced gastric cancer. Methods 37 patients with advanced gastric cancer were treated with paclitaxel liposome 135mg / m2 intravenously for 3h, d1; cisplatin 20mg / m2, intravenous d1 ~ 4; leucovorin 200mg / m2, intravenous infusion for 2h, d1 ~ 5; / m2, intravenous infusion of 4 ~ 6h d1 ~ 5.21d for l cycles, each patient treated for at least 2 cycles. Results The complete remission (CR) was observed in 2 of 37 patients (5.4%), partial response (PR) in 16 patients (43.2%), stable (SD) in 11 patients (29.7%) and progression (PD) in 8 patients , Total effective rate (CR + PR) 48.6% (18/37). The clinical benefit rate was 78.4%. The median TTP was 5.8 months and the median survival time was 10.6 months. Toxic side effects are mainly myelosuppression, gastrointestinal reactions, fatigue and hair loss. No treatment-related death occurred in all patients. Conclusion paclitaxel liposomes combined with cisplatin, fluorouracil for the treatment of advanced gastric cancer with certain efficacy, mild toxicity and good tolerance.