目的 比较PCF方案与POX方案一线治疗晚期胃癌的疗效和安全性.方法 58例晚期胃癌患者随机分为PCF方案组(30例)和POX方案组(28例).PCF方案:紫杉醇135 mg/m2静滴,d1；顺铂20mg/m2静滴,d1～d3;氟尿嘧啶500mg/m2持续静脉泵入,d1～d5.POX方案:紫杉醇135 mg/m2静滴,d1；奥沙利铂100 mg/m2静滴,d1；卡培他滨1000mg/m2口服,每天2次,d1～d14.两组均21天为1周期,两个周期评价疗效,比较两组的有效率(RR)、疾病控制率(DCR)、无进展生存期(PFS)和总生存期(OS).结果 58例患者均可评价疗效及毒副反应.PCF方案组与POX方案组相比,RR(46.7％ vs53.6％)、DCR(76.7％ vs.85.7％)、中位PFS(5.8个月vs.6.5个月)、中位OS(10.2个月vs.11.6个月)差异均无统计学意义(P＞0.05).PCF方案组3～4级中性粒细胞减少发生率明显高于POX方案组(30.0％vs.7.1％),而POX方案组腹泻(42.9％vs.16.7％)及周围神经毒性(50.0％vs.23.3％)更为常见,但多为1～2级.结论 POX方案与PCF方案一线治疗晚期胃癌的疗效相近,均可耐受,但不良反应情况有明显差异,前者在安全性和便利性方面更具优势.%Objective To compare the efficacy and safety of paclitaxel plus cisplatin and fluorouracil (PCF) and paclitaxel plus oxaliplatin and capecitabine(POX) as first-line therapy for advanced gastric cancer(AGC).Methods In this randomized study,58 patients with AGC were randomly assigned to either paclitaxel 135mg/m2on day 1 plus cisplatin 20mg/m2 on d1-3 and fluorouracil 500rng/m2 on d1-5 in a 21-day cycle(PCF regimen,n =30) or paclitaxel 135mg/m2 on day 1 plus oxaliplatin 100mg/m2 on day 1 and capecitabine 1000mg/m2 twice daily on d1-14 in a 21-day cycle(POX regimen,n =28).Results The efficacy and toxicity could be assessed among all patients.There were no significant differences in therapeutic efficacy between PCF and POX regimen with respect to response rate(46.7％ vs.53.6％),disease control rate(76.7％ vs.85.7％),median progression-free survival(5.8 months vs.6.5 months) and overall survival(10.2 months vs.11.6 months),respectively.Grade 3/4 neutropenia was more frequent with PCF regimen than POX regimen(30.0％ vs.7.1％),while diarrhea(42.9％ vs.16.7％) and peripheral neuropathy(50.0％ vs.23.3％) occurred more frequently with POX regimen.Conclusion PCF and POX regimen had similar efficacy for the first-line treatment of AGC,with different side effects,but acceptable toxicity profiles.POX regimen seemed to be more safe and convenient.
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