DF方案联合顺铂腹腔热灌注化疗治疗晚期胃癌的临床研究

 为观察和比较多西他赛周方案给药联合5-氟尿嘧啶(5-FU)和顺铂(DDP)静脉化疗与多西他赛(DOC)、5-氟尿嘧啶静脉给药联合顺铂腹腔热灌注,治疗晚期胃癌患者的初步疗效和副反应,将90 例晚期胃癌患者,随机分入多西他赛、5-氟尿嘧啶和顺铂静脉化疗组或多西他赛、5 氟尿嘧啶静脉化疗联合顺铂腹腔热灌注化疗组,静脉化疗组45 例,热灌注化疗组45 例.研究表明,静脉化疗组有效率为44.4%(20/45),热灌注化疗组为66.7%(30/45),其中完全缓解(CR)1 例,有统计学差异(P=0.038);临床受益反应(CBR)评估,静脉化疗组有效率为64.4%(29/45),热灌注化疗组为82.2%(37/45),差异有统计学意义(P=0.0458);两组副反应主要为骨髓抑制,胃肠道反应,神经毒性等,无统计学差异.多西他赛周方案、5-氟尿嘧啶联合顺铂腹腔热灌注化疗方案治疗晚期胃癌近期疗效优于单存静脉化疗,两组副反应相似,耐受性良好.

Treatment of Gastric Cancer with DF Regimen Combined with Hyperthermic Intraperitoneal Perfusion Chemotheraphy with Cisplatin

This study aims to observe and compare the efficacy and side effect of weekly docetaxel combined with 5-fluorouracil and cisplatin intravenous treatment and weekly docetaxel plus 5-fluorouracil intravenous combined with intraperitoneal perfusion (CHPP) with cisplatin treatment. Ninety patients with advanced gastric cancer were randomized into intravenous chemotherapy group (45 patients) who received docetaxel 36 mg/m², iv, 1wk×3wk, CF 200 mg/m², iv, d1-5, 5-Fu 500 mg/m², iv, d1-5, DDP 25 mg/m², iv, d1-3, repeated every four weeks for two cycles and intravenous chemotherapy plus CHPP group (45 patients) who received docetaxel 36 mg/m², iv, 1wk× 3wk, CF 200 mg/m², iv, d1- 5, 5- FU 500 mg/m², iv, d1- 5, DDP 75 mg/m², CHPP, d1, and abdomen hyperthermia treatment with radiofrequency. The results show that all patients were assessable for response in intravenous chemotherapy group and CHPP group. The overall response rate of intravenous chemotherapy group was 44.4%. The response rate of CHPP group was 66.7%, including one CR. There was statistical difference between two groups (P=0.038). The clinical beneficial response (CBR) in intravenous chemotherapy group and CHPP group were 64.4% and 82.2%, respectively. There was apparent statistical difference (P=0.0458). The major toxicities were myelosuppression, nausea/vomiting and neurotoxicity. There was no significant difference in side effect between the two groups. Docetaxel administered by weekly infusion plus 5-fluorouracil combined with hyperthermic intraperitoneal perfusion chemotherapy with cisplatin in the treatment of advanced gastric cancer is more effective than intravenous treatment. The side effect of two groups was similar. CHPP therapy was well tolerated.