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目的:探讨DOF方案〔多西紫杉醇+奥沙利铂(Oxaliplatin)+5-氟尿嘧啶(5-FU)〕对晚期胃癌的疗效、不良反应及预后的影响因素。方法:多西紫杉醇75 mg/m2,d1;奥沙利铂135 mg/m2,d1;5-FU 500 mg/m2,d1~d5;每21 d重复,至少接受2个周期,然后对所有患者进行随访至死亡为止。结果:DOF方案有效率为51.56%,中位疾病进展时间(TTP)6.8个月,中位总生存期(OS)10.2个月;其中初治组有效率66.67%,复治组有效率40.54%,两组差异有统计学意义,P<0.05;白细胞减少发生率81.25%(52/64),外周神经炎发生率为31.25%(20/64)。单因素生存分析显示,肝脏或腹膜转移、化疗周期不足4次者和化疗近期疗效较差者的预后不佳,多因素生存分析显示,近期疗效是晚期胃癌OS的独立预后因素。结论:多西紫杉醇联合奥沙利铂及5-FU治疗晚期胃癌疗效肯定,毒副反应较轻,患者均能耐受;化疗的近期疗效是晚期胃癌患者OS的独立预后因素。
Objective: To investigate the efficacy, adverse reactions and prognostic factors of DOF regimen [docetaxel + oxaliplatin + 5-fluorouracil (5-FU)] in advanced gastric cancer. Methods: Docetaxel 75 mg / m2, d1; oxaliplatin 135 mg / m2, d1; 5-FU 500 mg / m2, d1-d5; repeated every 21 d for at least 2 cycles. Follow up until death. Results: The effective rate of DOF was 51.56%, the median time to progression of disease (TTP) was 6.8 months, and the median overall survival (OS) was 10.2 months. The effective rate was 66.67% in initial treatment group and 40.54% , P <0.05; the incidence of leukopenia was 81.25% (52/64), and the incidence of peripheral neuritis was 31.25% (20/64). Univariate survival analysis showed that the prognosis of liver or peritoneal metastasis and chemotherapy less than 4 times and chemotherapy less recently had poor prognosis. Multivariate survival analysis showed that short-term efficacy was an independent prognostic factor for OS in advanced gastric cancer. Conclusions: Docetaxel combined with oxaliplatin and 5-FU in the treatment of advanced gastric cancer has certain curative effect, mild side effects and tolerability. The short-term effect of chemotherapy is an independent prognostic factor of OS in patients with advanced gastric cancer.