替吉奥联合紫杉醇对晚期老年胃癌患者的临床疗效评价

Clinical evaluation of efficacy of S-1 capsule combined with weekly paclitaxel treatment on elderly patients with advanced gastric cancer

目的评价替吉奥（S-1）联合紫杉醇治疗晚期老年胃癌患者的近期疗效及毒副反应，探讨适合老年胃癌患者的药物治疗方法。方法将38例晚期老年胃癌患者随机分为治疗组（n=20）和对照组（n=18）。治疗组采用紫杉醇联合替吉奥化疗：紫杉醇60mg／m2，第1、8、15天用药，替吉奥胶囊每1380mg／m2，分2次口服，连续口服14d，28d为1周期；对照组采用FP方案：顺铂15mg／m2，第1-5天静点，5．Fu750mg／m2，第1～5天静点，28d为1周期。两组患者至少治疗2周期后评价疗效及毒副反应。结果治疗组与对照组的有效率、疾病控制率、1年生存率分别为40．O％、22．2％，75．0％、50．0％和50．5％、38．9％，差异无统计学意义（P〉0．05）；治疗组患者KPS改善情况优于对照组，差异有统计学意义（P〈0．05）；治疗组的胃肠道反应及Ⅲ～Ⅳ度骨髓抑制明显低于对照组，差异有统计学意义（P〈0．05）。结论替吉奥口服联合紫杉醇周疗方案化疗有效率高，老年患者耐受性好，是老年晚期胃癌患者值得选择的化疗方案。

Objective To evaluate the efficacy and toxicity of S-1 capsule combined with weekly paclitaxel treatment on elderly patients with advanced gastric cancer. Methods 38 elderly patients with gastric cancer diagnosed in our hospital were randomly divided into 2 groups. Treatment group （20 patients）received 2 cycles （28 day/cycle） of paclitaxel combined with S-1 chemotherapy. Each cycle of the treatment consisted of paclitaxel： 60 mg/m2,intravenously on day-l, 8 and 15. S-1 capsule： 80 mg/m2, twice/day for 14 days. Control group （18 patients） received FP chemotherapy （Cisplatin： 15 mg/m2, intravenously every day from day-1 to day-15. Fluorouracil： 750 mg/m2, intravenously every day from day-1 to day-15）. The efficacy and toxicity were evaluated after 2 cycles of treatment. Results The efficacy of the treatment and control group was 40.0% and 22.2%, respectively. The disease control rate was 75.0% for the treatment group and 50.0% for the control group. The first year survival rate for the treatment group was 50.5% and 38.9%（P〉0.05）for the control group. The quality of life for the patients in the treatment was better than the control group （P〈0.05）. The gastrointestinal reaction and the degree of bone marrow suppression （Grade Ⅲ - Ⅳ ） of the treatment group were significantly lower than the control group （P〈0.05）. Conclusion Combined S-1 with weekly paclitaxel treatment was found to be efficient and well tolerated in elderly patients with advanced gastric cancer.