多西紫杉醇联合希罗达或替吉奥一线治疗晚期胃癌的临床观察

Clinical comparison of Docetaxel combined with S-1 or Capicitabine in treating advanced gastric carcinoma

目的:观察多西紫杉醇联合希罗达或替吉奥治疗晚期胃癌的疗效、疾病进展时间及不良反应。方法:86例晚期胃癌患者随机分为多西紫杉醇联合卡培他滨(TC组)和替吉奥(TS组)方案组进行化疗,其中TC组44例,TS组42例。对照组(TC组):多西紫杉醇每次剂量25mg/m2,加入生理盐水250ml,静脉滴注2h,第1、8、15天给药,卡培他滨每日1250mg/m2,分2次口服,d1-14;每28天重复。治疗组(TS组):多西紫杉醇用法同前,替吉奥80mg/(m2.d),口服,2次/天,第1-14天,每28天重复。结果:TC组有效率(RR)为43.2%,中位生存期(MST)10.9个月,中位疾病进展时间(TTP)4.5个月。常见不良反应为粒细胞减少及恶心呕吐、手足综合征。TS组RR为42.9%,MST为10.5个月,TTP为4.3个月。常见的不良反应为粒细胞减少及恶心呕吐等。TC组与TS组手足综合征发生率分别为63.6%及26.2%(P<0.05)。不良反应均可耐受。结论:多西紫杉醇联合卡培他滨和替吉奥方案治疗晚期转移性胃癌有较好的疗效,不良反应可以耐受,值得在临床进一步推广。

Objective：To observe the efficacy and side effect of Docetaxel combined with S - 1 or Capicitabine in treating advanced gastric carcinoma. Methods： Eighty - six advanced gastric carcinoma patients were divided into 2 groups randomly ：44 in TC group （Docetaxel plus Capecitabine） and 42 in TS group （Docetaxel plus S - 1 ）, TC group ： Docetaxel 25mg/m2 （ d1 , ds, d15 ）, Capecitabine 1250 rag/（ m2 d ） divided in two daily doses given from d1 todl4. TS group： Docetaxel 25rag/m2 （dI ,d8, d15 ）, S -1 80mg,/（ m2 ~ d ）divided in two daily doses given from d, to d14, in 2 groups repeated every 28 days. Restdts： RR in group TC and TS were 43.2% and 42.9%, respectively. TYP was 4.5 months in TC group and 4.3 months in TS group. MST was 10.9 months in TC group and 10.5 months in TS group. The most common adqerse effects in 2 groups were neutropenia, nausea and vomiting. The frequency of hand - foot syndrome was 63.6% in TC group and 25.0% in TS group（ P 〈 0.05 ）, respectively. The treatment was well tol- erated. Conclusion： TC and TS regimens with manageable toxicity have good anti- tumor activity on advance gastric