多西他赛联合奥沙利铂?氟尿嘧啶和亚叶酸钙方案治疗Ⅲ?Ⅳ期胃癌后再手术的临床疗效初步观察
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Resection of stage Ⅲ and Ⅳ gastric cancer after neoadjuvant chemotherapy with the combination of docetaxel,oxaliplatin fluorouracil and leucovorin
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    摘要:

    目的:探讨多西他塞联合奥沙利铂-氟尿嘧啶和亚叶酸钙治疗Ⅲ-Ⅳ期胃癌后再手术的临床疗效-方法:对2005年1月~2008年8月期间40例Ⅲ-Ⅳ期胃癌患者,第1 天应用多西他塞60 mg/m2-奥沙利铂75 mg/m2;第1~5天氟尿嘧啶500 mg/m2-亚叶酸200 mg/m2,每4周为1个周期,共2~3 个周期,化疗结束4~6 周后手术-结果:总有效率70%,病理客观有效率85%,根治性切除率62.5%-主要不良反应:骨髓抑制和恶心-呕吐-没有严重的化疗并发症;疾病进展时间(TTP)6.4个月,中位生存期(MST)20.6个月-结论:多西他塞联合奥沙利铂-氟尿嘧啶和亚叶酸钙方案治疗Ⅲ-Ⅳ期胃癌后再手术可以提高手术的根治率和切除率,并且具有较好的安全性和依从性-

    Abstract:

    Objective:To investigate the clinical effect on resection of stage Ⅲ and Ⅳ gastric cancer after neoadjuvant chemotherapy with the combination of docetaxel,oxaliplatin fluorouracil and leucovorin. Methods:From January,2005 to August,2008,40 patients with stage Ⅲ and Ⅳ gastric cancer received the neoadjuvant chemotherapy 4~6 weeks before operation. Neoadjuvant chemotherapy regimen consisted of 60 mg/m2 docetaxel(Day 1),75 mg/m2 oxaliplatin(Day 5),500 mg/m2 fluorouracil(Day 1 to 5)and 200 mg/m2 leucovorin(Day 1 to 5)administered every 4 weeks for 2~3 cycles before operation. Results:Objective response rates were 70%;Objective pathological response rates were 85%;Total resection rates were 85%;Curative resection rates were 62.5%;TTP was 6.4 months;MST was 20.6 months. Major side effects were myelosuppression,nausea and vomiting. No serious complications were observed. Conclusion:The overall curative resection rates and the compliance were increased in patients with the stage Ⅲ and Ⅳ gastric cancer after the neoadjuvant chemotherapy with the combination of docetaxel,oxaliplatin fluorouracil and leucovorin.

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周荣平,张有成,陈〓刚,程顺舟,沈志力.多西他赛联合奥沙利铂?氟尿嘧啶和亚叶酸钙方案治疗Ⅲ?Ⅳ期胃癌后再手术的临床疗效初步观察[J].南京医科大学学报(自然科学版),2010,(8):1183-1186

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  • 收稿日期:2010-02-08
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