替吉奥联合顺铂治疗晚期胃癌的临床观察

Study of S-1 combined with cisplatin in patients of advanced gastric cancer

目的观察替吉奥联合顺铂治疗晚期胃癌的近期疗效及不良反应。方法晚期胃癌患者27例,替吉奥根据体表面积给药,<1.25 m2,40 mg,bid;1.25～1.50 m2,50 mg,bid;>1.50 m2,60 mg,bid,早晚餐后口服,d1～14,顺铂;75 mg/m2,分d1、2,每21 d为1个周期,每完成2个周期评价疗效。结果 27例均可评价,其中完全缓解(CR)1例(3.7%),部分缓解(PR)14例(51.9%),稳定(SD)7例(25.9%),进展(PD)5例(18.5%),有效率(CR+PR)为55.6%(95%可信区间为35.5%～74.5%),疾病控制率(CR+PR+SD)为81.5%(95%可信区间为61.9%～93.6%)。主要不良反应表现为骨髓抑制、皮肤色素沉着及消化道反应。结论替吉奥联合顺铂治疗晚期胃癌近期疗效好,不良反应可以耐受,值得临床推广及进一步研究。

Objective To evaluate the efficacy and toxicity of the regimen of S-1 combined with cisplatin in patients of advanced gastric cancer. Methods Twenty seven patients of advanced gastric cancer were treated with the combination therapy of S-1 （doses based on patients＇ body surface area： 〈 1.25 m^2, 40 mg, bid;1.25 -1.50 m^2, 50 mg, bid; 〉1.50 m^2, 60 mg, bid, on days 1 through 14） plus cisplatin （75 mg/m^2 from day 1 through day 2） every 21 days. The evaluation of efficacy and toxicity was performed after every 2 cycles. Results All 27 patients were assessed for efficacy and toxicity. CR was achieved in 1 case （3.7%）, PR in 14 cases （51.9%）, SD in 7 cases （25.9%）, PD in 5 cases （ 18. 5% ）. The overall response rate was 55.6% （95% confidence interval： 35. 5% -74. 5% ） and the disease control rate was 81.5% （95% confidence interval： 61.9%-93.6% ）. The common toxicites of the regimen included myelosuppression, pigmentation and gastrointestinal reactions. Conclusions The regimen of S-1 plus cisplatin is effective against advanced gastric cancer with acceptable toxicity.