以奥沙利铂为基础的化疗方案治疗晚期胃癌

Oxaliplatin-based regimen for the treatment of advanced or metastatic gastric/esophagogastric junction cancer

目的评价以奥沙利铂（OXA）为基础的化疗方案治疗晚期胃癌和胃食管结合部腺癌的有效性和安全性。方法选择180例符合条件的以OXA为基础的化疔方案治疗的晚期胃癌或胃食管结合部腺癌患者，化疗方案为mFOLFOX（OXA＋5-氟尿嘧啶＋甲酰四氢叶酸）；mEOF（OXA＋表阿霉素＋5-氟尿嘧啶）和CapOX（OXA＋卡培他滨），按实体瘤的疗效评价标准（RECIST）评价客观疗效，按美国癌症研究所常见毒性判定标准（NCI—CTC）3．0版评价不良反应。结果180例患者总治疗周期数为717个，中位治疗3个周期。有150例可评价疗效，有效率为30．0％，疾病控制率（DCR）为74．0％。初治的124例中，103例可评价疗效，有效率为34．0％，DCR为74．8％，中位总生存期（OS）为11．3个月。复治的56例中，47例可评价疗效，有效率为21．3％，DCR为72．3％。无化疗相关性死亡，常见Ⅲ、Ⅳ级不良反应为粒细胞减少（17．8％）、白细胞减少（14．4％）和恶心呕吐（8．9％）。结论以OXA为基础的化疗方案治疗晚期胃癌和胃食管结合部腺癌有效，且不良反应可耐受。

Objective To evaluate the efficacy and toxicity of oxaliplatin-based regimen in patients with advanced or metastatic gastric/esophagogastric junction cancer （AGC）. Methods The clinieopathological data of a total of 180 patients with AGC were retrospectively analyzed. Responses was evaluated by RECIST criteria, and toxicity were assessed according to the NCI-CTC AE version 3.0. Results 155 patients received mFOLFOX regimen, and 25 patients received regimens of mEOF and CapOX, with a total chemotherapy of 717 cycles with a median of 3 cycles. The therapeutic response was evaluated in 150 patients, showing response rate（RR） of 30.0% and disease control rate （DCR） of 74.0%. The response was evaluated in 103 of 124 patients who received the therapy as 1st line, with RR of 34.0% , DCR of 74.8% , and overall survival of 11.3 months. The major grade Ⅲ/Ⅳ adverse events were leucocytopenia （ 14.4% ） , neutropenia （ 17.8% ）, thrombocytopenia （ 3.8% ）, nausea/vomiting （ 8.9% ）, and peripheral neuropathy （ 2.2% ）, with no treatment related death. Conclusion Oxaliplatin-based regimen is active and well tolerated in patients with advanced or metastatic gastric/esophagogastric junction cancer.