奥沙利铂联合替吉奥在胃癌术后辅助化疗中的安全性分析

A safety analysis in patients treated with oxaliplatin plus S-1 as adjuvant therapy for gastric cancer

目的探讨奥沙利铂联合替吉奥在胃癌术后辅助化疗中的安全性和耐受性。方法回顾性分析71例胃癌患者术后采用奥沙利铂联合替吉奥化疗的临床资料，分析其不良反应，并进行随访观察。结果71例胃癌术后患者中，17例采用奥沙利铂双周给药方案，54例采用奥沙利铂三周给药方案。常见的不良反应为恶心、呕吐51例（71．8％），中性粒细胞降低49例（69．0％），食欲下降49例（69．0％）；常见的3-4度不良反应为中性粒细胞降低13例（18．3％），血小板降低10例（14．1％），食欲下降5例（7．0％），恶心、呕吐4例（5．6％）。8例新辅助化疗患者术后行辅助化疗，其中7例（87．5％）发生血小板降低，4例（50．0％）发生3-4度血小板降低。≥65岁患者与〈65岁患者发生3-4度不良反应的差异均无统计学意义（均P〉0．05）。结论奥沙利铂联合替吉奥在胃癌术后辅助治疗中的不良反应是可以耐受的；术前接受新辅助化疗患者的耐受性较差；≥65岁的老年患者耐受性尚可。

Objective The combination of oxaliplatin and S-I is effective in patients with advanced gastric cancer. The purpose of this study was to analyze the safety and compliance of this combination regimen as adjuvant chemotherapy in patients with gastric cancer. Methods Clinical data of 71 patients with gastric cancer treated with oxalipiatin plus S-1 as adjuvant chemotherapy in the Cancer Hospital, Chinese Academy of Medical Sciences （CAMS） from Jan 1^at, 2010 to Jan 14, 2012 were retrospectiely reviewed. The types and incidence rote of adverse events related to chemotherapy and the results of follow up of the patients were analyzed. Results Among the 71 cases, 17 were treated with oxaliplatin biweekly, while 54 with oxaliplatin triweekly. The most common adverse events were neutropenia （n =49, 69.0% ）, nausea/vomiting （ n = 51, 71.8% ）, and anorexia （ n = 49, 69. 0% ）. The most frequent grade 3-4 toxicities were neutropenia （ n = 13,18. 3% ）, th^rda （ n = I0, 14. I% ）, anorexia （ n = 5, 7.0% ） and nausea/vomiting（n =4, 3.6% ）o Seven（87. 5% ）of the 8 patients previously treated with neoadjuvant chemotherapy experienced thrombocytopenia in the postoperative adjuvant chemotherapy, and four （50%） of the 8 patients experienced grade 3-4 thrombocytopenia. The rates of grade 3-4 adverse events in patients aged 6.5-years or older were similar to that in younger patients. Conctusions The combination of oxaliplatin and S-1 used as adjuvant chemotherapy is well tolerated by patients with gastric cancer. Neutropenia, thromhocytupenia, nansea/vomiting and anorexia are the major treatment-related adverse events. Patients who received neoadjuvant chenmtherapy do not well tolerate this regimen as postoperative adjuvant chemotherapy. This combination regimen has a manageable tolembility profile in adjuvant setting in patients 365 years old.