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目的评价多西他赛联合奈达铂、氟尿嘧啶(DNF方案)一线治疗晚期胃癌的临床疗效和毒副反应。方法 DNF方案一线治疗50例胃癌患者。具体用法:第1天多西他赛75 g/m2静脉滴注60 min;奈达铂100 mg/m2静脉滴注3 h,醛氢叶酸钙200 mg/m2静脉滴注2 h。随后氟尿嘧啶375 mg/m2静脉推注10 min,再以氟尿嘧啶2.6 g/m2持续泵入46 h。21 d一周期,每2周期按WHO疗效标准评价疗效,所有患者至少接受2周期化疗。结果 50例患者共接受194个周期的化疗,所有患者均可评价疗效。完全缓解2例(4%),部分缓解18例(36%),稳定10例(20%),进展20例(40%),总有效率为60%,中位疾病进展时间5.8个月,中位生存时间11.8个月。最常见的不良反应为血液学毒性及胃肠道反应,以Ⅰ、Ⅱ级为主。Ⅲ~Ⅳ级粒细胞减少、Ⅲ~Ⅳ级血小板减少、Ⅲ~Ⅳ级贫血的发生率分别为22%,6%,6%,其中2例Ⅲ~Ⅳ级粒细胞减少患者伴发热。消化道反应多为恶心呕吐,占68%,为多为Ⅰ、Ⅱ度;脱发发生率为56%,其中Ⅲ/Ⅳ度仅3例,占6%;肝肾毒性毒性轻微,无Ⅲ度及以上毒性。结论多西他赛联合奈达铂、氟尿嘧啶方案一线治疗晚期胃癌疗效较好、毒性较低,值得临床应用及进一步大样本、多中心研究。
Objective To evaluate the clinical efficacy and side effects of docetaxel combined with nedaplatin and fluorouracil (DNF regimen) in the first-line treatment of advanced gastric cancer. Methods DNF regimen first-line treatment of 50 patients with gastric cancer. Specific usage: 1 day docetaxel 75 g / m2 intravenous infusion of 60 min; nedaplatin 100 mg / m2 intravenous infusion of 3 h, calcium metaldehyde calcium folate 200 mg / m2 intravenous infusion of 2 h. Subsequent fluorouracil 375 mg / m2 intravenous injection of 10 min, then fluorouracil 2.6 g / m2 continuous pump 46 h. 21 d a cycle, every 2 cycles according to the WHO efficacy standard evaluation of efficacy, all patients received at least 2 cycles of chemotherapy. Results 50 patients received 194 cycles of chemotherapy, all patients can evaluate the efficacy. The complete remission was achieved in 2 cases (4%), partial remission in 18 cases (36%), stabilization in 10 cases (20%) and progression in 20 cases (40%) with a total effective rate of 60% The median survival time of 11.8 months. The most common adverse reactions for hematological toxicity and gastrointestinal reactions, mainly Ⅰ, Ⅱ grade. Ⅲ ~ Ⅳ neutropenia, Ⅲ ~ Ⅳ thrombocytopenia, Ⅲ ~ Ⅳ grade anemia rates were 22%, 6%, 6%, of which 2 patients with grade Ⅲ ~ Ⅳ neutropenia fever. Gastrointestinal reactions were mostly nausea and vomiting, accounting for 68%, mostly for Ⅰ, Ⅱ degrees; the incidence of hair loss was 56%, of which Ⅲ / Ⅳ degree only 3 cases, accounting for 6%; liver and kidney toxicity was mild, The above toxicity. Conclusions Docetaxel combined with nedaplatin and fluorouracil is the first-line treatment of advanced gastric cancer with better efficacy and lower toxicity, which is worthy of clinical application and further large sample and multicenter studies.