卡培他滨联合奥沙利铂或多西他赛治疗晚期胃癌的临床观察

Clinical Observation of Capecitabine Combined with Oxaliplatin or Docetaxel in the Treatment of Advanced Gastric Cancer

目的观察卡培他滨联合奥沙利铂或多西他赛治疗晚期胃癌的近期疗效和毒副反应。方法选择晚期胃癌患者59例，随机分入XELOX组和DX组。XELOX组30例，DX组29例。XELOX组奥沙利铂130mg／m2，第1天静脉滴注，卡培他滨1000mg／m2，日2次口服，第1～14天，每3周重复给药1次。DX组多西他赛75mg／m2，第1天静脉滴注，卡培他滨用法同前，每3周重复给药1次。2个周期化疗后进行疗效评价。结果所有59例患者均可评价疗效。XELOX组的有效率46．7％，其中CR1例（3．3％），PR1例（43．3％），SD8例（26．7％）。DX组的有效率41．4％，其中无CR病例，PR12例（41．4％），SD7例（24．1％）。两组患者的有效率无统计学差异（P〉0．05）。两组病例主要不良反应为骨髓抑制、胃肠道反应及外周神经毒性，多为Ⅰ-Ⅱ度，耐受良好。结论卡培他滨与奥沙利铂或多西他赛联合治疗方案均是晚期胃癌的有效的化疗方案，两种方案疗效及不良反应类似，患者耐受良好。

Objective To observe the efficacy and safety of capecitabine combined with oxaliplatin or docetaxel in the treatment of advanced gastric cancer. Methods 59 patients with advanced gastric cancer were randomized and devided into XELOX group （30 cases） and DX group（29 cases）. In XELOX group, patients received intravenous oxaliplatin 130mg/m2 on day l plus oral capecitabine 1000mg/m2 twice daily on days 1-14, every 3 weeks. In DX group, patients received intravenous docetaxel 75mg/m2 on day 1 plus oral capecitabine 1000mg/m2 twice daily on days 1-14, every 3 weeks. The efficacy and toxicity were evaluated when the treatment finished 2 cycles later. Results 59 patients were evaluable. The overall response rate of XELOX group was 46.7%,CR 1 patient （3.3%）, PR 13 patients （43.4%）,SD 8 patients （26.7%）. The overall response rate of DX group was 41.4%, PR 12 patients（41.4%）, SD 7 patients（24.1%）, no CR patients. The efficacy of the two groups had no significant difference. The main adverse events of the two groups were myelosuppression, gastrointestinal reactions and periphery neurotoxicity which were tolerant. Conclusions The combination of capectabine and oxaliplatin or docetaxel was found to be well tolerated and effective in patients with advanced gastric cancer.