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目的比较紫杉醇脂质体或紫杉醇联合替加氟、奥沙利铂治疗晚期胃癌的疗效和安全性。方法 62例初治的晚期胃癌患者分为紫杉醇脂质体组(A组,n=32)与紫杉醇组(B组,n=30),A组每周期予以紫杉醇脂质体135 mg·m~(-2),d 1,B组每周期予以紫杉醇135 mg·m~(-2),d 1,2组均联合替加氟500 mg·m~(-2),d 1～5,奥沙利铂130 mg·m~(-2),d 1。21 d为一个周期,2周期后评价疗效及安全性。结果 62例患者中有58例可评价疗效。A组总有效率47%,临床控制率为73%,B组总有效率46%,临床控制率71%,2组比较差异无显著意义(P>0.05),2组血液学毒性与神经毒性的发生率比较差异无显著意义(P>0.05),但A组的恶心、呕吐及过敏反应等的发生率明显低于B组(P<0.05)。结论紫杉醇脂质体或紫杉醇联合替加氟、奥沙利铂治疗晚期胃癌近期疗效相当,但过敏反应及胃肠道反应的发生率明显降低。
Objective To compare the efficacy and safety of paclitaxel liposomes or paclitaxel combined with tegafur and oxaliplatin in the treatment of advanced gastric cancer. Methods Sixty-two patients with newly diagnosed advanced gastric cancer were divided into paclitaxel liposome group (n = 32) and paclitaxel group (n = 30). Patients in group A were treated with paclitaxel liposome 135 mg · m ~ (-2), d 1 and group B were treated with paclitaxel 135 mg · m -2 every week, group d 1,2 and group tegafur 500 mg · m -2, d 1 ~ 5, Sullivan 130 mg · m -2, d 1.21 d for one cycle, two cycles after the evaluation of efficacy and safety. Results Of the 62 patients, 58 patients could evaluate the curative effect. The total effective rate was 47% in group A, the clinical control rate was 73%, the total effective rate in group B was 46% and the clinical control rate was 71%. There was no significant difference between the two groups (P> 0.05). The hematological toxicity and neurotoxicity (P> 0.05). However, the incidence of nausea, vomiting and anaphylaxis in group A was significantly lower than that in group B (P <0.05). Conclusion paclitaxel liposomes or paclitaxel combined with tegafur and oxaliplatin in the treatment of advanced gastric cancer have similar curative effect in recent years, but the incidence of allergic reaction and gastrointestinal reaction is significantly reduced.