多西他赛联合顺铂、氟尿嘧啶和亚叶酸的新辅助化疗方案治疗不能切除进展期胃癌的疗效观察.pdf
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多西他赛联合顺铂、 氟尿嘧啶和亚叶酸的新辅助
化疗方案治疗不能切除进展期胃癌的疗效观察
杨 王治国
交通大学附属第六人民医院普外科 ,上海 200233
[摘要 ] 背景与目的:手术治疗目前仍是无远处转移胃癌的标准治疗方法 ,但大多数胃癌患者就诊时已经是
进展期而不宜手术。新辅助化疗是指在外科手术术前给予化疗 ,其目的之一是通过缩小原发肿瘤使之可以进行手
术切除 ,最终延长生存期。本临床试验目的在于研究多西他赛 (商品名:泰索帝 )联合顺铂、 氟尿嘧啶和亚叶酸给药
方案术前进行诱导化疗对不能切除的进展期胃癌的临床疗效及毒副反应。方法:入组患者均为本院 2003年 6
月 —2005年 6月收治的 12例晚期胃癌而无法行根治手术者。术前的新辅助化疗方案为:泰索帝 75 mg/m2
、 顺铂
75 mg/m2
第 1天;氟尿嘧啶 500 mg/m2
、 亚叶酸 200 mg/m2
第 1～5天 ,每三周为一个周期 ,共两个周期。观察新辅助
化疗后原发病灶的变化情况并观察用药后的毒副反应。结果:新辅助化疗后 9例患者获得肿瘤减期 ,疗程结束后 4
～6周 8例进行根治性手术切除。临床完全缓解 (CR) 1例 ,部分缓解 ( PR) 8例 ,无变化 (NC) 3例 ,进展 ( PD) 0例 ,有效率 75% (9 /12) ,腹水消退率 63 . 6% (7 /11)。组织学效果:轻度有效 3例 ,中度有效 4例 ,显著有效 1例。副反
应主要为骨髓抑制、 腹泻、 恶心呕吐、 脱发 ,经对症以及营养支持治疗后均能缓解。结论:多西他赛加顺铂、 氟尿嘧啶
及亚叶酸的新辅助化疗方案在高度进展期胃癌的治疗中,对提高手术切除率疗效显著,耐受性良好。
[关键词 ] 新辅助化疗; 胃癌; 多西他赛; 顺铂; 氟尿嘧啶; 亚叶酸; 晚期
中图分类号: R735 . 2; R730 . 53 文献标识码:A 文章编号: 10072 3639 (2006) 052 03462 05
The comb i na ti on of docet axel , c ispl a ti n, fluorourac il and leucovor i n(CF) a s neoadjuvan t chemo2
therapy for the trea tmen t of non2 resect able advanced ga str i c cancer YANG Zhe, WAMG Zh i2 guo
(Depa rt m ent of Surgery, the S ixth People’ s Hospital of Shanghai , Shanghai J iaotong Univer sity, S hanghai
200233, China)
Correspondence to: YANG Zhe E2 m ail : yangzhe64188@126. com
[Abstract] Background and purpose: Radical surgery remains the main treat ment for patientswith resectable gastric
cancer . However, the maj ority of patients have advanced gastric cancerwith either extensive invasi on of tumor int o the adja2
cent organs, lymph nodes ormetastases when diagnosed . The advantage of neoadjuvant chemotherapy p ri or t o surgery in2
cludes the shrinking of the cancer s o that surgery becomes feasible for the patientswith inoperable cancer and ulti mately i m2
p rove their l ong2ter m outcome . We conducted a clinical trial t o evaluate the efficacy and t oxicity of docetaxel (T AX) , cisp l2
atin (CDDP) and fluorouracil (52 FU) p lus leucovorin (CF) as the neoadjuvant chemotherapy in the treat ment of non2resect2
able advanced gastric cancer . Methods : From June 2003 t o June 2005, 12 patients with non2resectable advanced gastric
cancerwere treated with docetaxel / cis p latin /52 FU /CF before operati on . Neoadjuvant chemotherapy regi mens consisted of
docetaxel (D) , 75mg/m2
(days 1) , cis p latin (C) , 75mg/m2
(days 1) , fluor ouracil (F) , 500mg/m2
(days 1 t o 5) p lus leuco2
vorin (CF) , 200mg/m2
(days 1 t o 5) and were administered every 3 weeks for 2～3 cycles before operati on . The i mmediate
res ponse and t oxicity were documented for each patient . Results : 9 of the 12 patientswere downstaged and 8 were radically
operated 42 6 weeks after the end of the neoadjuvant chemotherapy . The overall response rate was 75% with 8 . 3% CR and
66 . 7% PR, 25% NC, and the ascites disappeared in 63 . 6% (7 /11). Pathol ogical comp lete res ponse was found in 1 case .
Hist opathogical responses were scaled asmild, moderate and marked in 3, 4 and 1 cases, res pectively . The most common
t oxicitieswere bone marrow supp ressi on, nausea, vomiting, al opecia and hep t oses . The t oxicities were recoverable after
symp t omatic treat ment . Conclusi on s : The combinati on of docetaxel , cis p latin , fluor ouracil p lus leucovorin (CF) is a very
effective and well2t olerated regi men as neoadjvant chemotherapy for the patientswith non2resectable advanced gastric canc2
er .
[Key words] neoadjuvant chemotherapy; non2resectable advanced gastric cancer ; docetaxel ; cis p latin; flu2
or ouracil ; leucovorin; advenced
通讯作者: 杨 E2 mail : yangzhe64188@126. com
643
《中国癌症杂志》2006年第 16卷第 5期
CH I NA ONCOLOGY 2006 Vol . 16 No . 5
? 1995-2007 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved. 胃癌是最常见的恶性肿瘤 ,其治疗是以手术治
疗为主的综合治疗 ......
化疗方案治疗不能切除进展期胃癌的疗效观察
杨 王治国
交通大学附属第六人民医院普外科 ,上海 200233
[摘要 ] 背景与目的:手术治疗目前仍是无远处转移胃癌的标准治疗方法 ,但大多数胃癌患者就诊时已经是
进展期而不宜手术。新辅助化疗是指在外科手术术前给予化疗 ,其目的之一是通过缩小原发肿瘤使之可以进行手
术切除 ,最终延长生存期。本临床试验目的在于研究多西他赛 (商品名:泰索帝 )联合顺铂、 氟尿嘧啶和亚叶酸给药
方案术前进行诱导化疗对不能切除的进展期胃癌的临床疗效及毒副反应。方法:入组患者均为本院 2003年 6
月 —2005年 6月收治的 12例晚期胃癌而无法行根治手术者。术前的新辅助化疗方案为:泰索帝 75 mg/m2
、 顺铂
75 mg/m2
第 1天;氟尿嘧啶 500 mg/m2
、 亚叶酸 200 mg/m2
第 1～5天 ,每三周为一个周期 ,共两个周期。观察新辅助
化疗后原发病灶的变化情况并观察用药后的毒副反应。结果:新辅助化疗后 9例患者获得肿瘤减期 ,疗程结束后 4
～6周 8例进行根治性手术切除。临床完全缓解 (CR) 1例 ,部分缓解 ( PR) 8例 ,无变化 (NC) 3例 ,进展 ( PD) 0例 ,有效率 75% (9 /12) ,腹水消退率 63 . 6% (7 /11)。组织学效果:轻度有效 3例 ,中度有效 4例 ,显著有效 1例。副反
应主要为骨髓抑制、 腹泻、 恶心呕吐、 脱发 ,经对症以及营养支持治疗后均能缓解。结论:多西他赛加顺铂、 氟尿嘧啶
及亚叶酸的新辅助化疗方案在高度进展期胃癌的治疗中,对提高手术切除率疗效显著,耐受性良好。
[关键词 ] 新辅助化疗; 胃癌; 多西他赛; 顺铂; 氟尿嘧啶; 亚叶酸; 晚期
中图分类号: R735 . 2; R730 . 53 文献标识码:A 文章编号: 10072 3639 (2006) 052 03462 05
The comb i na ti on of docet axel , c ispl a ti n, fluorourac il and leucovor i n(CF) a s neoadjuvan t chemo2
therapy for the trea tmen t of non2 resect able advanced ga str i c cancer YANG Zhe, WAMG Zh i2 guo
(Depa rt m ent of Surgery, the S ixth People’ s Hospital of Shanghai , Shanghai J iaotong Univer sity, S hanghai
200233, China)
Correspondence to: YANG Zhe E2 m ail : yangzhe64188@126. com
[Abstract] Background and purpose: Radical surgery remains the main treat ment for patientswith resectable gastric
cancer . However, the maj ority of patients have advanced gastric cancerwith either extensive invasi on of tumor int o the adja2
cent organs, lymph nodes ormetastases when diagnosed . The advantage of neoadjuvant chemotherapy p ri or t o surgery in2
cludes the shrinking of the cancer s o that surgery becomes feasible for the patientswith inoperable cancer and ulti mately i m2
p rove their l ong2ter m outcome . We conducted a clinical trial t o evaluate the efficacy and t oxicity of docetaxel (T AX) , cisp l2
atin (CDDP) and fluorouracil (52 FU) p lus leucovorin (CF) as the neoadjuvant chemotherapy in the treat ment of non2resect2
able advanced gastric cancer . Methods : From June 2003 t o June 2005, 12 patients with non2resectable advanced gastric
cancerwere treated with docetaxel / cis p latin /52 FU /CF before operati on . Neoadjuvant chemotherapy regi mens consisted of
docetaxel (D) , 75mg/m2
(days 1) , cis p latin (C) , 75mg/m2
(days 1) , fluor ouracil (F) , 500mg/m2
(days 1 t o 5) p lus leuco2
vorin (CF) , 200mg/m2
(days 1 t o 5) and were administered every 3 weeks for 2～3 cycles before operati on . The i mmediate
res ponse and t oxicity were documented for each patient . Results : 9 of the 12 patientswere downstaged and 8 were radically
operated 42 6 weeks after the end of the neoadjuvant chemotherapy . The overall response rate was 75% with 8 . 3% CR and
66 . 7% PR, 25% NC, and the ascites disappeared in 63 . 6% (7 /11). Pathol ogical comp lete res ponse was found in 1 case .
Hist opathogical responses were scaled asmild, moderate and marked in 3, 4 and 1 cases, res pectively . The most common
t oxicitieswere bone marrow supp ressi on, nausea, vomiting, al opecia and hep t oses . The t oxicities were recoverable after
symp t omatic treat ment . Conclusi on s : The combinati on of docetaxel , cis p latin , fluor ouracil p lus leucovorin (CF) is a very
effective and well2t olerated regi men as neoadjvant chemotherapy for the patientswith non2resectable advanced gastric canc2
er .
[Key words] neoadjuvant chemotherapy; non2resectable advanced gastric cancer ; docetaxel ; cis p latin; flu2
or ouracil ; leucovorin; advenced
通讯作者: 杨 E2 mail : yangzhe64188@126. com
643
《中国癌症杂志》2006年第 16卷第 5期
CH I NA ONCOLOGY 2006 Vol . 16 No . 5
? 1995-2007 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved. 胃癌是最常见的恶性肿瘤 ,其治疗是以手术治
疗为主的综合治疗 ......
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