胃癌术后多西他赛联合顺铂序贯S-1方案辅助化疗的疗效观察

Clinical efficacy of docetaxel plus cisplatin sequentially combined with S-1 as adjuvant chemotherapy for gastric cancer after operation

目的探讨胃癌术后ⅢB~ⅢC期患者应用多西他赛联合顺铂6个周期后序贯S-1方案辅助化疗的临床疗效和安全性。方法回顾性分析2011年4月至2012年10月胃癌D2根治术后ⅢB~ⅢC期患者32例,术后4周开始接受辅助化疗。具体方案为:多西他赛75 mg/m^2静滴,d1;顺铂25 mg/m^2静滴,d1~d3,21天为1周期,化疗6个周期;序贯S-1 80mg/m^2,分两次口服,d1~d14,21天为1周期,口服至术后1年。观察全组患者的3年生存率、3年无复发生存率及不良反应。结果所有患者均按计划完成化疗。术后1、2、3年生存率分别为90.6%、81.2%、65.0%,1、2、3年无复发生存率分别为90.6%、81.2%、50.4%。术后辅助化疗的疗效与病理分期无关(P>0.05),而与淋巴结转移数目有关,淋巴结转移数目≤3枚者的3年生存率优于>3枚者(78.6%vs.54.2%,P<0.05)。化疗不良反应包括骨髓抑制、消化道反应及脱发等,以1~2级为主。结论对于有高危因素的胃癌术后患者给予多西他赛联合顺铂方案化疗6个周期后序贯S-1单药口服至术后1年的辅助化疗,术后生存率及无复发率相对较高,且安全性良好,是安全有效的术后辅助化疗方案。

Objective To evaluate the clinical efficacy and safety of docetaxel plus cisplatin sequentially combined S-1 for patients with gastric cancer of ⅢB-ⅢC stage after operation. Methods A total of 32 patients with gastric cancer of ⅢB-ⅢC stage treated with adjuvant chemotherapy 4 weeks after D2 radical resection were analyzed retrospectively. The adjuvant chemotherapy regimen was as follows ： doeetaxel 75mg/m^2 iv d1 ; cisplatin 25mg/m^2 iv d1-d3. Six cycles were applied with 21 days as a cycle. Then S-1 was o- rally given as fbllows： 80 mg/m^2 for 2 times daily from d1-d14 and 21 days were a eycle. S-1 was applied to 1 year after operation. Patients＇ 3-year survival, 3-year recurrence-free survival and adverse reactions were observed. Results All the patients accomplished chemotherapy in plan. The 1-, 2-and 3-year survival rate of 32 patients was 90. 6% ,81.2% and 65.0%, respectively. The 1-, 2-and 3-year recurrence-fi＇ee survival rate was 90. 6%,81.2% and 50.4%, respectively. The clinical efficacy was not associated with patho- logical stage, but with number of lymph nodes （ P〈0.05 ）. Patients bearing metastatic lymph nodes three or less had better 3-year sur- vival rate compared with those bearing lymph node more than 3 （78.6% vs. 54. 2%, P〈0. 05）. Adverse reactions included bone marrow suppression, gastrointestinal symptoms and hair loss, mainly in grade 1-2. Conclusion Doeetaxel plus eisplatin sequentially combined with S-1 as adjuvant chemotherapy for gastric patients with high risk can bring better overall survival, recurrence-free survival, and ad- verse effect are well-tolerated.