替吉奥联合顺铂与5-氟尿嘧啶联合顺铂一线治疗晚期胃癌的疗效比较

Comparison of S-1 plus cisplatin versus FP regimen in the treatment of advanced gastric cancer

目的比较替吉奥联合顺铂方案（SP方案）与5-氟尿嘧啶（5-Fu）联合顺铂方案（FP方案）一线治疗晚期胃癌的近期疗效及安全性。方法50例晚期胃癌患者随机分为2组，观察组（SP组）患者25例，替吉奥联合顺铂治疗：替吉奥40mg／m^2口服，每天2次，第1～14天；顺铂75mg／m^2，静脉滴注，第1天，21d为1个周期。对照组（FP组）患者25例，5-氟尿嘧啶联合顺铂治疗：顺铂80mg／m^2，静脉滴注，第1天；5-Fu800mg／（m^2·d）静脉滴注24h，第1—5天，21d为1个周期。治疗至少2个周期后评价两组患者的近期疗效及不良反应。结果SP组患者总有效率（RR）为56．0％，其中完全缓解（CR）1例，部分缓解（PR）13例；FP组患者RR为48．0％，其中CR1例，PR11例，差异无统计学意义（P〉0．05）。但SP组患者的临床受益率（CBR）为84．0％，优于FP组患者的68．0％，差异有统计学意义（P〈0．05）。两组患者的不良反应以骨髓抑制、消化道反应、肝功能异常及口腔黏膜炎为主。其中FP组患者的恶心、呕吐反应显著高于SP组。而SP组出现了较高的腹泻发生率，与FP组比较，差异有统计学意义（P〈0．05）。结论替吉奥联合顺铂方案一线治疗晚期胃癌疗效肯定，不良反应较轻。

Objective To evaluate the efficacy and toxicity of S-1 plus cisplatin （SP） regimen versus 5-Fu plus cisplatin （FP） regimen for patients with advanced gastric cancer. Methods Fifty patients with advanced gastric cancer were divided into two groups. Group SP with 25 patients （S-1 40mg/m2, bid, d1-d14; DDP 75mg,/m2 Ivgtt dl. Three weeks was a cycle）. Group FP with 25 patients（ DDP 80mg/m2 Ivgtt d1, 5-Fu 800 mg/（m2 . d）CIV, 24h ×5d. Three weeks was a cycle. ）. Curative effect and side effects of two groups were observed. Results In group SP and group FP,the response rate was 56. 0% and 48.0% , there was no significant differences （ P 〉 0. 05 ） ; but the clinical benefit rate was 84.0% and 68. 0% , there was significant differences （ P 〈 0, 05 ） Side effects mainly in bone marrow depression, nau- sea and vomiting, dysfunction of liver and oral mucositis. There were more nausea and vomiting in group FP （P 〈 0.05 ）, but more diarrhea in group SP（ P 〈 0. 05 ）. Conclusions S-1 plus cisplatin was effective on advanced gastric cancer, and adverse effects were tolerable. These results indicate that further clinical study is of great worth.