奥沙利铂联合卡培他滨治疗高龄晚期贲门癌的临床研究

Therapeutic Effects of Oxaliplatin Combined with Capecitable in Older Patients with Advanced Adenocarcinoma of the Gastric Cardia

目的:观察奥沙利铂(Oxaliplatin,L-OHP)联合卡培他滨(Capecitabine,CAPE)治疗高龄晚期贲门癌(Gas-tric cardiac adenocarcinoma,GCA)的疗效和安全性。方法:80例GCA患者,根据年龄分为高龄组(≥75岁)38例和对照组(<75岁)42例,均采用XELOX方案化疗,即L-OHP 65mg/m2静脉滴注2h,d1、d8,CAPE1000mg/m2口服,2次/天,d1～d14,21天为1个周期,连续4～6个周期。化疗2个周期后评价肿瘤化疗敏感性和吞咽困难改善情况;化疗结束4周后进行近期疗效和不良反应评价。结果:高龄组和对照组比较,化疗敏感性分别为76.3%(29/38)和78.6%(33/42),无显著性差异(χ2=0.058,P>0.05);吞咽困难改善率分别为86.8%(33/38)和81.0%(34/42),无显著性差异(χ2=0.509,P>0.05);两组近期疗效分别为78.9%(30/38)和78.6%(33/42),无显著性差异(χ2=0.002,P>0.05);两组不良反应均为可逆,两组相比无显著性差异(P>0.05)。结论:L-OHP联合CAPE治疗高龄晚期GCA疗效较好,改善症状快,不良反应患者可以耐受。

Objective： To evaluate the effects and safety of Oxaliplalin（L-OHP） combined with Capecitabine（CAPE） in ohler patients with advanced gastric cardiac adenocarcinoma（GCA）. Methods： Eighty patients wilh advaneed GCA were elassified into the ohter group （975 years） and the control group （〈75 years）. XELOX regimen was administered in both groups, i.e. L-OHP 65 mg/m^2 iv infusion 2h on dl and d8： CAPE 1000mg/m^2/d twice daily from dl to d14. The regimen was given for 4-6 cycles, with 21 days in each cycle. Patient response and swallow status were evaluated after 2 cycles （6 weeks）. The effects and toxicity were assessed at 4 weeks after the chemotherapy regimen was completed. Results： The response rate was 76.3%（29/38） in the older group and 78.6%（33/42） in the control group （x^2=0.058, P〉0.05）. The rate of swallow improvement was 86.8%（33/38） in the ohler group and 81.0% （34/42） in the control group （x^2=0.509, P〉0.05）. The efficacy was 78.9%（30/38） in the older group and 78.6%（33/42） in the control group （x^2=0.002, P〉0.05）. The toxicity was similar and reversible in both groups （P〉0.05）. Conclusion： Combination chemotherapy of L-OHP plus CAPE is an effective, safe and well-tolerated regimen for treating older patients with advanced GCA.