摘要目的 探讨紫杉醇脂质体联合小剂量顺铂及5-氟脲嘧啶(5-Fu)治疗晚期胃癌的近期疗效及安全性.方法 紫杉醇脂质体60 mg/m2,第1,8,15天,静滴;顺铂15 mg·m-2·d-1,第1～5天;5-Fu 500 mg·m-2·d-1,持续静脉泵入,第1～5天(共120 h);21 d为1个周期,2个周期后评价疗效和毒副反应.结果 60例晚期胃癌患者中,有59例患者可评价疗效.其中完全缓解(CR)3例,部分缓解(PR)29例,总有效率为54.2%,中位疾病进展时间(TTP)为7.1个月.40例初治患者中,CR 3例,PR 22例,总有效率为62.5%,中位TTp为7.6个月;20例复治患者中,19例患者可评价疗效,PR 7例,总有效率为36.8%,中位TTP为6.3个月.全组不良反应主要为血液学毒性及消化道反应,大部分为Ⅰ、Ⅱ度.结论 紫杉醇脂质体联合顺铂及5-Fu治疗晚期胃癌疗效肯定,特别对初治患者,不良反应轻,患者均能耐受,值得临床进行大样本研究.

abstractsObjective To evaluate the efficacy and toxicity of paclitaxel with low-dose cisplatin and 5-fluorouracil continuous infusion in the treatment of advanced gastric carcinoma. Methods The patients were treated with paclitaxel liposome 60 mg/m2 I. V. Gtt on dl, 8, 15, DDP 15 mg · m-2 · D-1 by I. V. Gtt on dl -5, 5-Fu 500 mg · m -2 · d -1 by civ for 120 h, administered every 21 days. Results Out of the whole group, 3 cases achieved CR, 29 cases achieved PR with an ORR of 54.2% and median TTP of 7. 1 months. Out of 40 cases in the primary treatment, 3 cases achieved CR, 22 cases achieved PR with an ORR of 62.5% and median TTP of 7.6 months. Out of 20 evaluable retreated cases, no case achieved CR, 7 cases achieved PR with an ORR of 36. 8% and median TTP 6. 3 months. The main toxicities were hematological toxicities, nausea and vomiting of grade I - II. Conclusion The combination regimen of paclitaxel, lowdose cisplatin and 5-fluorouracil is effective and well tolerated for patients with advanced gastric carcinoma, especially for primary treatment cases. It is worthy of further study.