曲妥珠单抗联合卡培他滨及奥沙利铂治疗晚期胃癌疗效研究

Transtuzumab combined with capecitabine and oxalipatin in treatment of advanced gastric cancer

目的通过荧光原位杂交(FISH)法检测胃癌Her-2基因扩增状况,评价曲妥珠单抗联合卡培他滨及奥沙利铂(Xelox方案)治疗晚期胃癌的效果。方法 FISH法检测32例晚期(Ⅳ期)胃癌患者Her-2基因均为扩增,按治疗方法不同分为两组:A组18例,采用曲妥珠单抗+Xelox方案治疗,B组14例,单用Xelox方案治疗。结果 A组疗效优于B组,差异有统计学意义(P<0.05)。两组治疗后的不良反应均较轻,主要表现腹泻15例(49.2%),恶心、呕吐10例(32.1%),血白细胞下降27例(85.5%),手足综合征9例(29.6%),Ⅰ度肝功能损害11例(33.9%)。无一例发生心脏毒性反应。结论曲妥珠单抗联合Xelox方案治疗Her-2阳性晚期胃癌是有效、安全可行的。

Objective To evaluate the efficacy of transtuzumab combined with capecitabine and oxalipatin in treatment of gastric cancer. Methods Thirty two Her- 2 positive patients with advanced gastric cancer（stage IV）, admitted from January 2010 to October 2012, were randomly assigned into two arms：18 patients in arm A received transtuzumab combined with capecitabine and oxalipatin （Xeolx）, 14 patients in arm B receive Xeolx regime alone. Results Therapeutic efficacy of arm A was better than that of arm B（P〈0.05）. The adverse effects were gently in both groups,and mainly displayed I-II degree diarrhea（49.2%）, nau-sea and vomiting （32.1%）, bone marrow depression （85.5%）, hand and foot syndrome （29.6%）, and I degree liver function lesion （33.9%）. No case developed heart toxic reaction. Conclusion Transtuzumab combined chemotherapy is effective and safe for Her- 2 positive patients with advanced gastric cancer.