中文摘要：

目的探讨奥沙利铂（oxaliplatin,L-OHP）、多西紫杉醇（docetaxel,DOC）和羟基喜树碱（hydroxy camptothecine,HCPT）联合5-氟尿嘧啶（5-Fluorouracil,5-Fu）/亚叶酸钙（calcium folinate,CF）组成的序贯化疗方案治疗晚期胃癌（advanced gastric cancer,AGC）的疗效和不良反应。方法入组35例AGC患者,以序贯方式依次接受L-OHP＋5-Fu/CF、DOC＋5-Fu/CF和HCPT＋5-Fu/CF方案化疗,每个方案连用2周期,均每3周重复,共6周期化疗;观察疗效和不良反应,并随访疾病进展情况。结果35例均能评价疗效,总缓解率（RR）为60%（21/35）,中位肿瘤进展时间（TTP）为7.6月,95%置信区间（CI）（7.0～8.2）,中位生存期（OS）15.1月,95%CI（14.2～16.0）;不良反应程度较轻,主要为骨髓抑制、胃肠道反应、脱发及过敏反应,但均可逆,未出现因化疗毒性而死亡病例。结论 L-OHP、DOC和HCPT联合5-Fu/CF的序贯化疗是AGC有效治疗方案,化疗耐受性好,新颖的序贯化疗模式在AGC中应用值得进一步研究。

英文摘要：

Objective To observe the efficacy and adverse reaction of sequential chemotherapy consists of oxaliplatin,docetaxel and hydroxy camptothecine plus 5-fluorouracil to advanced gastric cancer（AGC）.Methods Thirty-five patients were all treated with chemotherapy of L-OHP＋5-Fu/CF,DOC＋5-Fu/CF and HCPT＋5-Fu/CF in sequence,every chemotherapy regimen was used continuously 2 cycles and repeated every 21 days.All patients received 6 cycles totally.Efficacy and toxicity were evaluated.Results The clinical efficacy has been evaluated in all 35 patients.The whole response rate（RR）was 60%（21/35）,the median time to progression（TTP） was 7.6 months,95% confidence interval（CI）ranged 7.0-8.2 months,the median overall survival（OS）was 15.1 months,95% CI ranged 14.2-16.0 months.The major toxic reactions included marrow suppression,nausea,vomiting,alopecia and allergic reactions,but all of them are reversible.No patients were dead from toxic reactions of chemotherapy.Conclusion The sequential chemotherapy of L-OHP,DOC and HCPT plus 5-Fu is an effective and tolerable regimen for AGC.The innovative chemotherapy schema deserves clinical expansion and further exploration in the future.