紫杉醇脂质体联合奥沙利铂和替吉奥方案治疗晚期胃癌临床观察

Clinical Observation of Paclitaxel Liposomes Combined with Oxaliplatin and S-1Capsule in the Treatmet of Patients with Advanced Gastric Cancer

目的观察紫杉醇脂质体联合奥沙利铂和替吉奥方案治疗晚期胃癌患者,探讨其疗效及安全性。方法初治的晚期胃癌患者22例,均给予紫杉醇脂质体175mg/m2,静脉滴注3h,第1天;奥沙利铂130mg/m2,静脉滴注2h,第2天;替吉奥胶囊根据体表面积来确定初始剂量,体表面积<1.25m2给予40mg,bid,体表面积1.25~1.5m2给予50mg,bid,体表面积>1.5m2给予60mg,bid,早、晚饭后口服,连续服用14d,21d为1周期。至少完成2个周期后进行疗效和不良反应评价。结果 22例均可评价疗效,其中完全缓解0例,部分缓解10例,稳定9例,进展3例,客观有效率(ORR)为45.5%,疾病控制率86.4%。中位疾病进展时间(TTP)为5.1个月,中位生存时间(OS)为11.7个月。最常见的毒副反应为血液学毒性,III^IV度白细胞降低发生率为13.6%;其余胃肠道反应、外周神经毒性、脱发等较轻,以I^II度为主;无化疗相关性死亡病例。结论紫杉醇脂质体联合奥沙利铂和替吉奥方案一线治疗晚期胃癌疗效较高,毒副反应较轻,多数患者耐受良好,值得扩大样本进一步研究。

Objective To evaluate the efficiency and toxicity of paclitaxel liposomes combined with oxaliplatin and S1 capsule in the treatment of advanced gastric cancer. Methods Twenty-two patients with advanced gastric cancer were treated with the combination therapy of paclitaxel liposomes （175 mg/m2 on day 1 for 3 h） combined with oxaliplatin （130 mg/m2 on day 2 for 2 h） and S-1 （doses based on patients＇ body surface area： 〈1. 25 m2 ,40 rag,bid;1.25-1.50 m2 ,50 mg,bid;〉1. 50 m2 ,60 mg,bid） ,on day 1 after breakfast and dinner,for totally 14 d,21 d as a course. The evaluation of efficacy and toxicity was performed after 2 courses. Results The overall response rate （ORR） was 45.5 % and the disease control rate was 86. 4% （CR 0, PR 10, SD 9, PD 3）, and median time to progression （TTP） and median overall survival time （OS） were 5. 1 months and 11. 7 months, respectively. The common toxic effects were hematological toxicities and the incidence of grade Ⅲ-Ⅳ leucopenia was 13.6%. Non hematologic toxicities were fairly mild and the majority was grade Ⅰ - Ⅱ No occurrence of treatment related deaths was observed. Conclusion The regimen of paclitaxel liposomes combined with oxaliplatin and S-1 is effective and tolerable with toxic effects in the treatrnent of patients with advanced gastric cancer.