紫杉醇联合氟尿嘧啶、亚叶酸钙治疗老年晚期胃癌.doc

1 紫杉醇联合氟尿嘧啶、亚叶酸钙治疗老年晚期胃癌作者:钟海均,应杰儿,刘碧霞,杨云山【摘要】[目的] 探讨紫杉醇联合氟尿嘧啶持续滴注加亚叶酸钙治疗老年晚期胃癌的疗效及毒副反应。[ 方法] 32 例胃癌患者应用紫杉醇 135mg/m2 ,分第 1、8 天静滴, 亚叶酸钙( CF ) 100mg/m2 第1、2、3 天静滴,氟尿嘧啶(5-Fu)500mg/m2 第1 天静滴 2h ,以后用 5-Fu 2500mg/m2 泵内持续滴注,持续 70h , 21~28 天为 1 个周期,至少 2 个周期开始评价疗效。[结果] 30 例患者可评价疗效,获 PR1 2 例, NC8 例, PD10 例, 全组未见 CR 病例, 总有效率为 % , 中位 TT P为 个月; 其中初治患者19 例总有效率为 % , 中位 TTP 为 个月;复治患者 13 例总有效率为 % ,中位 TTP 为 个月。毒副反应主要为Ⅰ~Ⅱ度血液学毒性及消化道反应。[ 结论] 紫杉醇联合氟尿嘧啶持续滴注加亚叶酸钙治疗老年晚期胃癌疗效肯定, 患者均能耐受。特别对初治患者,值得深入研究。 2 【关键词】 bination of Paclitaxel, 5-Fluorouracil and Leucovorin in the Treatment for Elderly Patients with Advanced Gastric Cancer Abstract: [ Purpose ] To investigate the efficacy and toxicity bination of paclitaxel, 5-fluorouracil (5-Fu) and leucovorin (CF) in elderly advanced gastric cancer. [ Methods ] Thirty-two cases with gastric cancer were enrolled. Paclitaxel 135mg/m2, d1, d8; CF 100mg/m2, d1~3; and 5-Fu 500mg/m2, intravenously over 2h on day 1, followed by continuous intravenous infusion ata dose of 2500mg/m2 for 70h. The treatment was repeated every 21 or 28 days, and efficacy was evaluated after two cycles. [ Results ] Thirty patients were evaluated for clinical response. Twelve cases were 12 partial response (PR); 8, stable disease (SD); 10, progressive disease (PD) and 0, complete response(CR). The overall response rate (ORR) was % and the median TTP was months. Of 19 patients initially treated, the ORR was % and TTP was months. Of 13 previously treated cases, the ORR was % and TTP was months. The main toxicities revealed 3 myelosupression and gastrointestinal toxicity with grade Ⅰ~Ⅱ. [ Conclusion ] Combination of paclitaxel, 5-Fu and CF regimen is an effective and well tolerable for elderly advanced gastric cancer, especially for initial treatment. Key words: gastric neoplasms; chemotherapy; paclitaxel; fluorouracil 胃癌是我国最常见的恶性肿瘤, 老年患者的发病率也越来越高。由于老年患者脏器的储备功能往往较年轻患者差,而且大多数都合并多种基础疾病,往往不能耐受强烈化疗,在化疗方案的选择上既要注意高效, 又要注意安全性、耐受性和高效性之间的平衡。因此利用新药