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Objective: Gastric cancer is one of the common malignant tumors, the incidence 10-150/10 million global annual new cases of about 100 people, the highest in four of all malignancies, about 700,000 deaths per year, mortality rates The malignancies second. Although the incidence of gastric cancer is a downward trend in recent years, but the prognosis of the disease did not change significantly, worldwide five-year survival rate is still only 5% -15%. The low rate of early diagnosis of gastric cancer, gastric cancer clinical found mostly in the late. Surgical resection is the preferred method of treatment for gastric cancer, but more than 50% of patients diagnosed metastasis, underwent radical surgical resection line gastrectomy patients have 50% in five years, the local recurrence and distant metastasis . Advanced gastric cancer patients with poor prognosis, an important means of chemotherapy treatment of advanced gastric cancer. In recent years, continuously improve the efficacy of cancer chemotherapy, but there is no uniform standard treatment regimen. 5-FU in the treatment of gastric cancer is still one of the main drug irreplaceable. The vast majority of the treatment of tumors of the gastrointestinal tract specification program contains 5-FU and its derivatives. Paclitaxel for cell cycle-specific drugs, the major toxic effects of 5-Fu is not superimposed, no cross-resistance, the combination can significantly improve the efficacy. The famous trial of V325 affirmed the clinical status of the DCF regimen in gastric cancer chemotherapy ,5-Fu taxane-based joint program has been NCCN (2007) gastric cancer clinical practice guidelines as a category 1 evidence. The purpose of this study is the evaluation of paclitaxel combined with fluorouracil the clinical efficacy security of different modes of administration of advanced gastric cancer. Methods: collection of Dalian Medical University Second Affiliated Hospital oncology January 2006 - 2009 12 menstrual cases of 63 patients with advanced gastric cancer patients pathology data, divided into four groups, group one: the paclitaxel 135-175mg/m2 first one day, intravenous infusion, 5-FU: 300mg/m2 first 1-7 days, continuing pumped every 3-4 weeks for a course of treatment; groups: paclitaxel 60mg/m2 first 1,8,15 days, intravenous drip Note 5-FU: 500mg/m2 first 1-5 days, intravenous infusion, CF 20mg/m2 on days 1-5, every 4 weeks for a course of treatment: groups of three: the paclitaxel 135-175mg/m2 first day, intravenous infusion, 5-FU: 400mg/m2 day 1, 2 intravenous 600mg/m222 hours CIV days 1, 2, CF 200mg/m2 on day 1, 2, intravenous infusion, Monday regimen: group of four: paclitaxel 60mg/m2 first 1,8,15 days intravenously, fluorine special hydrochloride capsules 120mg / d, orally, divided into morning and evening, on days 1-14, 4-week course of treatment. Evaluated after two courses. Such as CR.PR or SD can continue treatment. CR.PR must confirm efficacy after 4 weeks. Four groups contrast observed efficacy and adverse events. Efficacy assessed according to RECIST \Adverse reactions common adverse reactions according to the WHO \SPSS15.0 software for statistical analysis, measurement data using analysis of variance efficient compared using Kruskall-Wallis test, two groups χ2 test was used to compare the efficiency of survival using the Kaplan-Meier method analysis, Log-rank test , P lt; 0.05 difference was statistically significant. Results: 1. Divided into groups A and B (A group is group 1 to group 3 that three weeks dose group; B group for group 2 plus group that week dose group) A group of 39 cases, according to the different modes of administration of paclitaxel efficiency of 23.07%, 58.97% tumor control rate. Group B, 24 patients, 41.7% efficiency, clinical benefit rate of 87.5%. Weekly paclitaxel combined 5-Fu for advanced gastric cancer than three weeks dose, the difference was statistically significant (P lt; 0.05). 2 in accordance with the different modes of administration of 5-FU were divided into four groups, the efficient four groups were 11.1%, 41.6%, 33.3% and 41.6%. Group efficiency compared, the difference was statistically significant (P lt; 0.05). Pairwise comparisons show that the effective rate of the five days of continuous administration group, and fluoride special triazine group is better than low-dose 5-Fu group. 3.63 patients, the median survival time of 53 evaluable cases, four groups in median overall survival time were: the group of 18 cases in a median survival of 10.1 months; Group II 12 patients with a median survival of 9.4 months; groups of three 12 patients with a median survival of 10.8 months; Group 4:12 patients with a median survival of 10.5 months. The lifetime of the difference was not statistically significant (P lt; 0.05). Adverse reactions were myelosuppression, nausea, vomiting, and peripheral nerve toxicity, diarrhea. 4 toxicity compared the difference was not statistically significance (P gt; 0.05). Five days of continuous administration of diarrhea was higher than the fluoride special triazine group. Conclusion: 1. Weekly paclitaxel combined with fluoropyrimidine treatment of advanced gastric cancer is better than three weeks dose paclitaxel fluoropyrimidine. . Paclitaxel combined with fluorine special hydrochloride capsules in the treatment of advanced gastric cancer than paclitaxel combined with low-dose 5-FU, and easy to use, good safety, toxicity can be tolerated. Paclitaxel combined with low-dose 5-FU is optional for the PS score is poor, senior citizens and other patients with poor tolerance. 4.
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