| Objective:Stomach cancer is a common malignant tumours, morbidity 10-150/100,000, the global annual incidence cases about 1 million people, the highest in all malignant tumor in fourth place, die every year about 700,000 people, mortality rates in a malignant tumor 2. In recent years stomach cancer incidence, although there was a downward trend in the disease in advance, and no significant change, the global context of the five year survival rate is only 5 percent to 15 percent. Stomach Cancer Early detection rate is low and clinical found in the stomach most of the late, surgery to remove the stomach cancer treatment in the first direct election, but 50 percent of the patients have been confirmed, transfer, and cannot be cured of surgery. About 50% of gastric cancer patients appeared recurrence and metastasis after radical resection. Advanced stomach cancer patients prognosis is poor, to focus on the integrated treatment of advanced stomach cancer treatment in the important means. Although in recent years stomach cancer chemotherapy in increasing the efficacy, but there is no uniform standard treatment program. In the treatment of stomach cancer 5-fluoroura-cil is still no alternative to the main drug. The majority of the treatment of gastrointestinal, oncology Normative program, which contains 5-fluoride urine pyrimidine and its derivatives. The paclitaxel for the cell cycle speci-ficity medicine, does not superimpose mellowly with the 5-Fu main toxic effect, the not overlapping drug resistance, the union application may enh-ance the curative effect obviously. The famous V325 experiment had affirm-ed the DCF plan in the stomach cancer chemotherapy clinical status, take the taxus class,5-Fu as the foundation union plan has been listed as 1 kind of evidence by NCCN(2007) stomach cancer clinical practice guide.The purpose of this study was to evaluate different injection methods of pacli-taxel combined with fluorouracil in advanced gastric cancer the clinical efficacy and safety.Methods:The date of 63 cases of pathologically confirmed advanced gastric cancer from January,2006 to December,2009 were collected in the Oncological Department of Second Affiliated Hospital of Dalian Medical University and were randomly divided into four groups. Group 1:since taxol 135-175 mg/m 2 dl intravenous drip,5-FU:300 mg/m2 d1-7 day sustained pumps, each 3-4 weeks for treatment of Group 2:paclitaxel 60 mg/m 2dl,8,15 intravenous drip,5-FU:500 mg/m 2 d1-5 intravenous drip, CF 20 mg/m2 d1-5, every 4 weeks for treatment; Group 3:paclitaxel 135-175 mg/m2 dl intravenous drip,5-FU:400 mg/m 2, d1,2 intravenous 600 mg/m 2 22 hours CIV CF 200 mg/m2 dl-2 intravenous drip note,3 week treatment; Group 4:paclitaxel 60 mg/m2, d1,8,15 days intravenous drip, S-1 120 mg/d oral, sooner or later,1-14 days to four weeks each treatment. After two treatment efficacy evaluation. If CR PR, or SD may continue to treatment. CR, PR must be in four weeks after confirming its efficacy. Four recent comparative study of efficacy and adverse reactions. Short-term effect based on RECIST "Response Evaluation Criteria in Solid Tumors," assessment. Adverse reactions according to WHO "anti-cancer drug comm-only occurring adverse reactions grading standards" evaluation. Using the SPSS 15.0 software for statistical analysis, measurement data using analysis of variance was used to compare multiple sets of efficiency Kruskall-Wallis test was used to compare the two groups and efficient X2 test, P<0.05 showed statistically significant.Results:1. In accordance with paclitaxel were divided into group A with different administration methods and the B (A group for the group 1 plus group 3 is a three-week dose group; B group as group 2 plus group 4 that week dose group) A group of 39 cases,23.07% efficient, rate of tumor control rate of 58.97%. B group of 24 cases, efficiency was 41.7% clinical benefit rate was 87.5%. Weekly paclitaxel combined 5-Fu is better than three weeks for advanced gastric cancer dose, the differen(?) was statistically significant (P<0.05).2.5-fluorouracil administered in accordance with different methods were divided into four groups, four effective rates were 11.1%,41.6%, 33.3%,41.6%.4 The total effect rate was significantly (P<0.05). Pairwise compa-rison showed that continuous treatment group and 5 days special fluoride hydrochloride group than the effective rate of low-dose 5-Fu group.3.6 patients,53were evaluable median survival time, four median overall survival time were:group one 18 patients, median survival 10.1 months; group two 12 patients with median survival was 9.4 months; Group three The median survival of 12 cases of 10.8 months; group four of 12 cases of median survival time was 10.5 months. Survival difference was not statisti-cally significant (P<0.05).4. Adverse effects of bone marrow curb, nausea, around nerve toxic and diarrhoea. Group 4 drug Deputy respond more, there is no difference between statistical significance (P>0.05). Five days group diarrhoea incid-ence rate higher than fluorine special seminars group.Conclusion:1. Weekly paclitaxel combined with fluorouracil treatment of advanced gastric cancer drugs better than the three-week paclitaxel combined with fluorouracil drugs.2. Paclitaxel special fluoride hydrochloride capsules treating advanced gastric cancer is better than low-dose paclitaxel plus 5-Fu, and ease of use, security is good, toxicity can be tolerated.3. Paclitaxel combined with low dose 5-fluorouracil selectively used for poor PS score, age and other patients with poor tolerance.
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