不同化疗方案一线治疗老年晚期胃癌的近期疗效分析

Clinical Analysis of Different Chemotherapy Regimens as Fist-line treatment for Advanced Gastric Cancer in Elder Patients

目的比较替吉奥胶囊联合奥沙利铂方案与FOLFOX4治疗老年晚期胃癌的近期疗效及毒副反应。方法选取南昌市第一医院诊治的65例老年进展期胃癌患者为研究对象,按收治时间顺序随机交叉分入替吉奥联合奥沙利铂治疗组(观察组,33例)和FOLFOX4治疗组(对照组,32例),每组完成至少3个周期的化疗方案后评价疗效和不良反应。结果观察组、对照组总有效率和疾病控制率差异不明显。末次随访为201 3年1 0月,65例患者死亡54例,观察组、对照组中位PFS时间分别为6.1和5.7个月,中位总生存期(OS)时间分别为10.1个月和9.5个月,组间对比差异不明显。化疗期间观察组Ⅲ级~ⅣV级的恶心呕吐显著低于对照组(P<0.05),且对照组中2例患者出现深静脉置管相关感染。观察组和对照组患者生存质量评分增加,组间对比差异显著(P<0.05)。结论替吉奥、奥沙利铂联合化疗方案与FOLFOX4方案具有相似疗效,且该方案应用更方便,降低了深静脉置管相关并发症的风险,消化道毒副反应小。

Objective To study the efficacy and toxicity of S-1 combined with oxaliplatin in the treatment of advanced gastric cancer in elder patients. Method Total of 65 elder patients with advanced gastric cancer proved pathologically in 1 st hospital of Nanchang were divided into 2 groups across according to the admission date. 33 cases in the observation group received the S-1 combined with oxaliplatin regimen while 32 cases in the control group received the FOLFOX 4 regimen. Efficacy was evaluated at least 3 cycles. Results The overall response rate and disease control rate between observation group and control group had no obvious differences. The last followed up was September 2013, 54 patients were dead. The median FPS of observation group and control group were 6.1 months and 5.7 months respectively, and the median OS time of observation group and control group were 10.1 months and 9.5 months respectively. The differences between two groups had no statistical significance. The rate of level III^IV adverse digestive reaction was higher in control group than that in the observation group. And there were 2 cases had deep vein catheter related infection in control group. The life quality score were increased in both observation group and control group, and there were obvious differences between two groups. Conclusion S-1 capsules combined with oxaliplatin regimen had same effective rate compared to FOLFOX 4 regimen.And adverse digestive system reaction in S-1 capsules combined with oxaliplatin regimen was less than FOLFOX 4 regimen. Nevertheless, it conveniently to oral method, and could reduce the rate of deep vein catheter related infection.