消化外科 2004年第3卷第2期90 - 92

    Journal of Digestive Surgery , 2004 ,3(2) :90 - 92

    ·临床研究· 文章编号: 1671 - 4555(2004) 02 - 0090 - 03

    多西紫杉醇P 顺铂P 52氟脲嘧啶新辅助化疗方案治疗

    局部进展期胃癌的临床研究

    赵冰 王建生 任宏

    【摘要】 目的 了解多西紫杉醇加顺铂及52氟脲嘧啶的联合新辅助化疗方案治疗局部进展期胃

    癌的疗效和毒副作用。方法 自2001年10月～2003年9 月 ,有 37 例局部进展期胃癌病人入组本次

    临床研究。入组病例术前接受的新辅助化疗方案为:多西紫杉醇75 mgP m2

    ,第1 天;顺铂 75 mgP m2

    ,第

    1天;52氟脲嘧啶500 mgP m2

    ,第1 - 5天 ,每三周为一周期 ,共三个周期。观察新辅助化疗后肿瘤原发

    病灶的缓解情况 ,并观察新辅助化疗的毒副反应。结果 新辅助化疗后所有病人进行了根治性手术

    治疗 ,临床有效率为51. 4 % ,其中完全缓解(CR)占8. 1 %(3例) ,部分缓解(PR)占43. 2 %(16例) ,疾病

    稳定(SD)占27. 0 %(10例) ,疾病进展(PD)占 21. 6 %(8 例) ,术后病理水平缓解率为 10. 8 %(4P 37) ,其

    中2例达到完全缓解。毒副反应主要为白细胞减少症、腹泻、恶心P 呕吐、脱发 ,共有 8 例病人发生了

    Ⅲ～ Ⅳ级的白细胞减少症 ,但未有因此而发生的败血症和死亡病例。结论 多西紫杉醇加顺铂及

    52氟脲嘧啶的新辅助化疗方案在进展期胃癌的治疗中近期疗效显著 ,耐受性良好。

    【关键词】 胃肿瘤 化疗 多西紫杉醇 顺铂 52氟脲嘧啶

    【中图法分类号】 R735. 2 【文献标识码】 A

    The combination of docetaxel and cisplatin and fluorouracil as neoadjuvant chemotherapy in the treatment

    of advanced gastric cancer Zhao Bing , Wang Jiansheng , Ren Hong. Oncology Surgery , First Hospital of

    Xi’ an Jiaotong University , Xi’ an 710061

    【Abstract】 Objective To evaluate the efficacy and toxicity of docetaxel(TAX) plus cisplatin(CDDP) plus

    fluorouracil (5 2FU) as the neoadjvant chemotherapy in the treatment of locally advanced gastric cancer(LAGC) . Meth2

    ods From October 2001 to September 2003 , 37 cases of LAGC patients were treated with DCF chemotherapy before op 2

    eration. Neoadjvant chemotherapy regimens containing docetaxel(D) , 75 mgP m2

    (days 1) plus cisplatin(C) , 75 mgP m2

    (days 1) plus fluorouracil (F) , 500 mgP m2

    (days 1 to 5) were administered every 3 weeks for three cycles before local

    treatment. The response in the primary tumor and the chemotherapy toxicity were observed in each patient . Results

    The response in the primary tumor : clinical efficacy rate was 51. 4% (8. 1% CR and 43. 2% PR , 27. 0% SD and 21.

    6% PD) . Pathological response rate was 10. 8%, pathological complete response was found in 2 cases. The most com 2

    mon toxicities were leukocytopenia , nauseaP vomiting and alopcia. Leucopenia of grade 3～4 was reported in 8 cases of

    the patients but there was no chemotherapy related toxic death. Conclusions The combination of docetaxel plus cispla 2

    tin plus fluorouracil is a very effective and well 2tolerated regimen as neoadjvant chemotherapy for the LAGC.

    【Key words】 neoadjvant chemotherapy locally advanced gastric cancer docetaxel cisplatin

    fluorouracil

    迄今为止 ,胃癌的首选治疗方案仍为手术切

    除。早期胃癌根治术后 5 年生存率在 90 %以上 ,但临床所见者大多数为进展期胃癌 ,单纯手术治

    疗效果尚不理想。通常在2年之内有50 %～60 %

    作者单位: 710061 西安交通大学第一医院肿瘤外科

    的患者复发和转移[1 ]。目前国内外的研究结果证

    实对局部进展期胃癌患者行术前行新辅助化疗 ,可进一步提高外科治疗疗效 ......