奥沙利铂联合卡培他滨治疗38例晚期胃癌的疗效

Oxaliplatin Plus Capecitabine for Advanved Gastric Cancer:Report of 38 Cases

目的探讨奥沙利铂联合卡培他滨(XELOX)方案治疗晚期胃癌的疗效和安全性。方法回顾性分析2004年5月至2009年10月北京协和医院肿瘤内科收治的使用XELOX方案治疗晚期胃癌患者38例。化疗方案:奥沙利铂静滴2h,第1天给药;卡培他滨分2次口服,第1～14天给药;每3周重复。按实体瘤的疗效评价标准评价疗效,按美国国立癌症研究所的常见不良反应判定标准评价毒副反应。结果 3周期后评价疗效:一线化疗34例、二线化疗4例。一线化疗患者中32例可评估,完全缓解0例(0.0%)、部分缓解8例(25.0%)、疾病稳定14例(43.8%)、疾病进展10例(31.2%)。中位随访9.5个月(4～46个月),23例出现疾病进展,中位无进展生存时间为7.0个月(95%CI为4.5～9.5个月);20例已死亡(均为肿瘤相关死亡),中位总生存时间为12.0个月(95%CI为9.8～14.2个月);1年生存率40.6%、2年生存率23.7%。3～4度不良反应主要有粒细胞减少(10.5%)、血小板减少(2.6%)、恶心(7.9%)、呕吐(5.3%)。结论 XELOX作为一线化疗方案治疗晚期胃癌有效、安全。

Objective To evaluate the efficacy and toxicity of the combination chemotherapy of oxali-platin with capecitabine(XELOX)in patients with advanced gastric cancer.Methods Thirty-eight advanced gastric cancer patients who received XELOX regimen during 2004-2009 were analyzed retrospectively.The combination chemotherapy included oxaliplatin as 2-hour infusion on day 1 and capecitabine po bid on days 1 to 14.Treatment was repeated every 3 weeks.Results XELOX regime was applied as first-line therapy in 34 pa-tients and as second-line therapy in 4 patients.After three cycles of chemotherapy,the outcomes in 32 patients who received XELOX as the first-line therapy included partial response(n = 8,25.0%),stable disease(n = 14,43.8%),and progressive disease(n = 10,31.2%);no patient achieved complete response.The median time to progression and overall survival time were 7.0 months(95% CI:4.5-9.5 months)and 12 months(95% CI:9.8-14.2 months),respectively.One-year and two-year survival rates were 40.6% and 23.7%,respectively.Grade 3-4 toxicities including neutropenia(10.5%),thrombocytopenia(2.6%),nausea(7.9%),and vomitting(5.3%)were noted in a few patients.Conclusion XELOX regimen can be effectively and safely applied as first-line treatment for advanced gastric cancer patients.