低剂量替吉奥联合奥沙利铂治疗高龄晚期贲门癌

Effect of Low-Dose Gimeracil and Oteracil Potassium Combined with Oxaliplatin on Aged Patients with Advanced Gastric Cardiac Adenocarcinoma

目的:评价低剂量替吉奥联合奥沙利铂治疗高龄晚期贲门癌的近期疗效和安全性。方法:60例年龄75岁以上晚期GCA按区组随机法分为低剂量组32例和对照组28例,替吉奥低剂量组50 mg/m^2,对照组80 mg/m^2,均bid口服,d1～d14,同时联合L-OHP 65 mg/m^2静滴2 h,d1,d8,21 d为1个周期,至少完成4个周期。结果:低剂量组与对照组有效率(RR)分别为59.4%、59.3%;疾病控制率(DCR)分别为93.8%、88.9%,差异均无统计学意义(P>0.05);不良反应发生率低剂量组、对照组中性粒细胞减少分别为46.9%、75.0%;贫血分别为53.1%、78.6%;血小板减少分别为43.8%、71.4%,差异均具有统计学意义(P<0.05)。结论:替吉奥50mg/m^2联合奥沙利铂治疗高龄晚期贲门癌,与80mg/m^2比较疗效相近,不良反应发生率降低,患者耐受性和治疗依从性更好,推荐进一步研究应用。

Objective： To evaluate the effects and safety of low-dose Gimeracil and Oteracil Potassium combined with Oxaliplatin （ L-OHP ） for aged patients with advanced gastric cardiac adenocarcinoma （ GCA ）. Methods： Sixty advanced GCA patients aged over 75 years were randomized into the low-dose （ LD ） group （ n = 32; 50 mg/m2 ） and the control group （ n = 28; 80 mg/m2 ）. Gimeracil and Oteracil Potassium capsules were administered orally for both the LD and the control group, twice daily for 14 days. A combined therapy with L-OHP was administered synchronously to both groups at 65 mg/m2 i.v. drip for 2 h on d 1 and d 8. The regimen was repeated for at least 4 cycles, with 21 days for each cycle. Results： The response rate （ RR ） was 59.4% in LD group and 59.3% in the control group; the disease control rate （ DCR ） was 93.8% in LD group and 88.9% in the control group （ P〉 0.05 ）. As for the side effects, the incidence of neutropenia was 48.4% in LD group and 75% in the control group （ P〈 0.05 ）, anemia 53.1% in LD group and 78.6% in the control group （ P〈 0.05 ）, and thrombocytopenia 43.8% in LD group and 71.4% in the control group （ P〈 0.05 ）. There was a statistical significance between the two groups. Conclusion： Gimeracil and Oteracil Potassium Capsules （ 50 mg/m2 ） combined with Oxaliplatin has similar efficacy to that of Gimeracil and Oteracil Potassium Capsules （ 80 mg/m2 ） combined with Oxaliplatin for aged patients with advanced GCA, with lower incidence of side effects and better tolerance.