替吉奥或奥沙利铂联合紫杉醇脂质体治疗进展期胃癌的临床分析

Clinical outcomes of advanced gastric cancer patients treated with chemotherapy of paclitaxel liposome combined with S-1 or oxaliplatin

比较替吉奥或奥沙利铂联合紫杉醇脂质体治疗进展期胃癌的疗效及安全性。方法：将118 例进展期胃癌患者随机分为两组，A 组61例接受紫杉醇脂质体＋ 替吉奥方案，B 组57例接受紫杉醇脂质体＋ 奥沙利铂方案；比较两组近期疗效、中位疾病进展时间、中位生存时间、体能状态和不良反应。结果：A 组ORR、DCR 、mTTP分别为31.1% 、75.4% 、4.2 个月，B 组分别为29.8% 、71.9% 、3.8 个月，差异均无统计学意义（P〉0.05）；两组mOS 分别为10.5 个月和8.9 个月，差异有统计学意义（P〈0.05）。 B 组Ⅲ～Ⅳ度腹泻及外周神经毒性发生率较A 组严重（P〈0.05）。 结论：两种含紫杉醇脂质体化疗方案应用进展期胃癌的近期疗效相当，提示替吉奥/紫杉醇脂质体方案在总生存期和耐受性方面可能优于奥沙利铂/紫杉醇脂质体方案。

Objective： This study aimed to compare the efficacy and adverse reactions of two different chemotherapeutic regi -mens. In particular, chemotherapy with paclitaxel liposome was administered in combination with either S-1 or oxaliplatin as the first-line therapy of advanced gastric cancer. Methods：A total of 118 patients with advanced gastric cancer were randomly divided into groups A （61cases） and B （ 57cases）. In group A, paclitaxel liposome combined with S-1 was administered; in group B, paclitaxel lipo-some combined with oxaliplatin was applied. The short-term efficacy, adverse reactions, Karnofsky performance status score, median time to progression （mTTP）, and median overall survival （mOS） of the two groups were observed and compared. Results： No signifi-cant differences were observed in the objective response rate, disease control rate, and mTTP between groups A and B （ 31.1% vs. 29.8%,75.4% vs. 71.9%,4.2 months vs. 3.8 months;P〉0.05）. The mOS rates were 10.5 and 8.9 months in groups A and B, respectively, with statistically significant differences （P=0.006）. The incidence of degrees Ⅲto Ⅳdiarrhea and peripheral nerve toxicity was signifi -cantly higher in group B than in group A （P〈0.05）. No statistical differences were found between the two groups in terms of other side effects. Conclusion：The two paclitaxel liposome-based regimens showed similar therapeutic effect in patients with advanced gastric cancer. S- 1/ paclitaxel liposome treatment could be more effective in terms of mOS and had a tendency of lower toxicity.