The Clinical Observation Of The 379 Advanced Gastric Cancer Cases Treated With The Chemotherapy Regimens Containing Paclitaxel

Objective : Currently there was no standard internationally regimen in the first line treatment for the advanced-gastric cancer.In recent years ,Multi-phase II clinical research indicates that Taxol gained better effect in the advanced-gastric cancer.This study aim to evaluate the efficacy and safety for the Taxol-based combined chemotherapy regimens and provide the evidences for the first line treatment.Methods : We non-randomized-controlled retrospectively analyzed the 379 advanced-gastric cancer patients who were treated in our hospital from 2003.01 to2008.12 .They were accepted the Taxol+OXA+CF+5-FU(95 cases) Taxol+ CF+ 5-Fu(167 cases) Taxol+OXA(94 cases) Taxol alone(23cases) respectively at least 2 cycle in the first line. Taxol + CF +5- Fu group, drug dose is: Taxol 100-135mg/m2 d1, CF 0.2/m2 d1-2 ,5-Fu 2.0-2.4/m2 civ for 48h, 2-8 cycles of chemotherapy cycles The median number of cycles is 5 cycles Taxol + OXA dose group was: Taxol 100-135mg/m2 d1, OXA 75-85mg/m2 d2, 2-8 cycles of chemotherapy cycles, the median number of treatment cycles 4 cycles Taxol + OXA + CF +5- Fu group, drug dose is: Taxol 100-135mg/m2 d1, OXA 75-85mg/m2 d2, CF 0.2/m2 d1-2 ,5-Fu 2.0-2.4/m2 civ for 48h , 2-8 cycles of chemotherapy cycles, the median number of treatment cycles 6 cycles Single-agent dose of the drug Taxol group: Taxol 100-135mg/m2 d1, 2-8 cycles of chemotherapy cycles, the median number of treatment cycles 3 cycles. We evaluate the RR DCR PFS OS and side effect of the four groups.Results The RR DCR PFS OS of single regimen in Taxol+OXA+CF+5-Fu Taxol+CF+5-Fu Taxol+OXA Taxo were 47.30%vs52.13%vs60.00%vs39.13%89.22 vs92.55%vs89.47%vs69.56% 11.4mvs11.7mvs11.7mvs7.5m6.6mvs7.2mvs7.2mvs4.1m respectively. The major toxicities were nausea, vomiting, loss of appetite, fatigue, bone marrow suppression, peripheral neuritis, etc.Oxaliplatin with which the incidence of peripheral neuropathy was significantly higher than non-oxaliplatin group (4.76% VS 0%; P <0.01), Taxol + OXA + CF +5- Fu group of hematologic toxicity was significantly higher than that of Taxol + CF +5- Fu group (52.63% VS 39.52%; P <0.01) and Taxol + OXA group (52.63% VS 29.78%; P <0.01); Thus, Taxol + OXA + CF +5- Fu group neutrophil Cells to reduce the incidence of fever as high as 7.37%, higher than the other group the occurrence rate of 4%.Conclusion : The taxol-based chemotherapy regimens has better short term effect and higher disease control rate .They can be the first line chemotherapy regimens for the advanced gastric cancer . First-line use of Taxol + OXA + CF +5- Fu, Taxol + CF +5- Fu, Taxol + OXA chemotherapy for advanced gastric cancer patients, initial treatment received advantage in PR / CR compared with SD / PD effects on survival , OS extended 4.9-7.3 months, PFSextendedf 4.4-5.2 months...