Clinical Study Of Weekly Dose Of Paclitaxel Combined With Low Dose Of FP Regiment In The Treatment Of Patients With Advanced Gastric Carcinoma

Objective: To observe the efficacy, the survival duration, the clinical benefit response and the adverse effects of weekly dose of Taxol combined with low dose of 5-FU and PDD for the treatment of patients with advanced gastric carcinoma. Methods: 14 patients with advanced gastric carcinoma were treated by TFP regiment . Taxol 70~80mg/m2 for 3 hours on days 1,8,15 were administered by intravenous infusion in conjunction with low dose of 5-FU 300mg/m2 by continuous infusion for 14 days and low dose of PDD 5mg for 5 days every week until 2 weeks. The course above was repeated every 4 weeks. The efficacy was evaluated after 2 cycles.Results: Among 14 patients with advanced gastric carcinoma, 4 patients only finished 1 chemotherapy cycle(quitting because of disease progression or economy). 10 patients were eligible for response evaluation underwent chemotherapy. There were 5 (50%) objective response, including 1 complete responses and 4 partial responses. The median response duration was 7 months (2~32+months). The median time to progression was 11.5 months (2~34+months). The median survival period was 14.5 months (5~34+months). The 1-year survival rate was 70%. Seventy percent of patients attained a clinical benefit response. 14 patients were eligible for toxicity evaluation underwent chemotherapy. Myelosuppression, alimentary tract reactions and alopecia were main toxicities caused by chemotherapy. Myelosuppression mainly expressed grade I to II neutropenia that observed in 10 patients(71.4%), without grade III-Ⅳ neutropenia. The ratios of thrombocytopenia and anemia were 21.4(3/14) and 14.3(2/14). In non-hematological toxicity, alimentary tract reactions included nausea and vomiting ,oral inflammation , diarrhea, the ratios were 35.7(5/14), 50%(7/14), 14.3%(2/14),respectively, which all were grade I to II toxicity; 5 patients developed alopecia(35.7%). Peripheral neuropathy developed in 4 patients(28.6%). There were no sensitive reaction, neutropenia–related fever and death caused by chemotherapy. There were no damage of hepatic and renal function. Electrocardiogram is observed no change. Patients were well tolerated.Conclusion: Paclitaxel was a novel anticancer drug. Compared to three-week administration, there were obvious clinical efficacies and less adverse effects in the treatment of patients with advanced gastric carcinoma while weekly dose of Taxol combined with low dose of 5-FU and PDD were administered. Further study should be carried out.