替吉奥联合奥沙利铂治疗晚期胃癌的疗效观察

Clinical observation of S-1 combined with oxaliplatin in treatment of advanced gastric cancer

目的探讨替吉奥(S-1)胶囊联合奥沙利铂(L-OHP)治疗晚期胃癌的近期疗效及不良反应。方法将52例晚期胃癌患者随机分为两组,观察组26例采用替吉奥40mg/m2,早、晚2次餐后服用,第1～14天;奥沙利铂130mg/m2第1天静脉滴注2 h,3周为1个周期。对照组26例,采用奥沙利铂联合亚叶酸钙+5-氟尿嘧啶方案,奥沙利铂130mg/m2第1天静脉滴注2 h;亚叶酸钙200mg/m2,静脉滴注第1、2天;5-氟尿嘧啶400mg/m2,静脉滴注2 h第1、2天,5-氟尿嘧啶600mg/m2,静脉滴注22 h,第1、2天,3周为1个周期。2个周期评价疗效及不良反应,所有患者均完成2个周期治疗。结果观察组26例患者的有效率(RR)为46.1%,疾病控制率(DCR)为76.9%,KPS评分改善率为66.2%;对照组26例患者的有效率(RR)为50.0%,疾病控制率(DCR)为80.7%,KPS评分改善率为58.2%,两组比较差异均无统计学意义(均P>0.05)。不良反应主要为血液学毒性、胃肠道反应和神经毒性,两组患者恶心、呕吐发生率分别为30.8%和57.7%,两组比较差异有统计学意义(P<0.05)。结论替吉奥联合奥沙利铂治疗晚期胃癌患者安全有效,服用方便,值得临床进一步推广研究。

Objective To explore the short-term efficacy and toxicity of oxaliplatin（L-OHP） combined with S1 capsule in treatment of advanced gastric cancer.Methods fifty-two advanced gastric cancer patiens were randomly divided into two groups.twenty-six patients in abservation group was given S-1 40mg/m2,twice po daily for 14 days,L-OHP 130mg/m2 ivgtt d1,3weeks as 1 cycle,twenty-six patients in control group was given Oxaliplatin（L-OHP） combined with calcium folinate and 5-Fu,L-OHP 130mg/m2 d1 ivgtt 2h,calcium folinate 200mg/m2,ivgtt d1-2,5-Fu 400mg/m2 ivgtt 2h d1-2,5-Fu 600mg/m2,ivgtt 22h,d1-2,3weeks as 1 cycle,the short-term efficacy and toxicity were evaluated after 2 cycles.Results In the observation group with the 26 patients,The effective rate（RR） was 46.1%,the disease control rate（DCR） was 76.9%.KPS mark improvement rate was 66.2%.In the control group with the 26 patients,The effective rate（RR） was 50.0%,the disease control rate（DCR） was 80.7%.KPS mark improvement rate was 58.2%.The two groups was no significant difference（P0.05）.The main side effects included myelosuppression,gastrointestinal reaction and neurotoxicity.Conclusions Oxaliplatin（L-OHP） combined with S1 capsule in treatment of patients with advanced gastric cancer has better efficacy and safty.