替吉奥联合奥沙利铂治疗晚期胃癌的临床观察

Clinical study of S-1 plus oxaliplatin in the treatment of advanced gastric carcinoma

目的探讨替吉奥(S-1)联合奥沙利铂(L-OHP)治疗晚期胃癌的临床疗效及安全性。方法 64例进展期胃癌患者分为两组,替吉奥联合奥沙利铂组(治疗组)34例,替吉奥每天80mg/m2,早晚各服1次,连服14d;奥沙利铂130mg/m2第1天,静脉滴注2h,3周为1个周期。卡培他滨联合奥沙利铂组(对照组)30例,同时口服希罗达每次1000mg/m2,每天2次,第1～14天;奥沙利铂130mg/m2第1天,静脉滴注2h,每3周为1个周期。4个周期后评价疗效及毒性。结果 64例患者均可评价疗效,治疗组和对照组的有效率分别为55.9%和53.3%,疾病控制率分别为79.4%和73.3%,两组差异均无统计学意义(P>0.05)。两组不良反应主要为血液学毒性、恶心呕吐、腹泻、外周神经毒性等,以I～II度为主,患者均可耐受。结论替吉奥联合奥沙利铂方案治疗晚期胃癌疗效好,且不良反应可耐受。

Objective To evaluate the efficacy and toxicity of the combination of S-1 and oXalipla- tin for patients with advanced gastric carcinoma. Methods 64 advanced gastric patients were divided into two groups. Treatment group（S-I ＋L-OHP） ：34 patients were treated with S-1 80mg/m-2 · d-1 from dl to d14, while L-OHP was administered 130mg/m2 on dl, 3 weeks for a cycle. Control group（XELOX regi- men） ：30 patients were treated with capecitabine 2000mg/m2 from dl to d14 and L-OHP 130mg/m2 dl, 3 weeks for a cycle. Efficacy and toxicities were evaluated after 4 cycles. Results All the patients were eligi- ble. The total response rates were 55.9% in the treatment group and 53.3% in the control group. And the disease control rates were 79. 4% and 73.3%, respectively. There was no significant difference between the two groups（P 〉0. 05 ）. Major toxicities were similar in the two groups, including bone marrow depression, nausea and vomiting, diarrhea, peripheral nerve toxicity. All these side effects were well tolerated. Conclu- sions S-1 combined with oxaliplatin is effective and well tolerated in the treatment of patients with ad- vanced gastric carcinoma.