奥沙利铂联合替吉奥一线治疗晚期胃癌效果

Effect of Oxaliplatin and Tegafur as first-line treatment for advanced gastric cancer

目的 探讨奥沙利铂联合替吉奥一线治疗晚期胃癌的临床效果及安全性。方法 选取2010年10月～2011年10月在济宁医学院附属医院住院治疗的126例晚期胃癌患者为研究对象，将126例晚期胃癌患者分为观察组（64例）和对照组（62例），观察组给予奥沙利铂联合替吉奥治疗（第1天，奥沙利铂130mg／m^2缓慢静脉滴注2h；第1～14天给予替吉奥40mg]m^2，口服，2次／d，于餐后服用，21d为1个疗程），对照组给予5-氟尿嘧啶＋奥沙利铂＋亚叶酸钙联合治疗（第1天，5-氟尿嘧啶400mg／m^2静脉滴注，奥沙利铂130mg]m^2缓慢静脉滴注2h，亚叶酸钙200mg／m^2静脉点滴，第2天给予5-氟尿嘧啶600mg／m^2持续静脉泵输注，连续输注24h，14d为1个疗程），观察两组患者治疗效果及毒副作用等情况。结果 观察组有效率（RR）和疾病控制率（DCR）为42．19％和62．50％，对照组RR和DCR为35．48％和54．84％，两组疗效比较差异无统计学意义（P〉0．05）；观察组临床获益率为67．19％，明显高于对照组的41．94％（P〈0．05）；观察组患者恶心呕吐发生率为10．94％，明显低于对照组的79．03％（P〈0．05），其他各毒副作用发生率比较差异均无统计学意义（P〉0．05）；两组患者化疗2个疗程后CD4^＋和CD4^＋／CD8^＋均有显著上升（P〈0．05）；观察组化疗2个疗程后CD4^＋和CD4^＋／CD8^＋高于对照组（P〈0．05）；观察组患者疾病进展时间（TTP）为8-42个月，明显长于对照组的4．65个月（P〈0．05）；两组患者中位生存时间（MST）比较差异无统计学意义（P〉0．05）。结论 奥沙利铂联合替吉奥治疗晚期胃癌可延缓疾病进展时间，具有临床获益率高、毒副作用较小、患者耐受性好等优点，且可在一定程度上提高患者细胞免疫功能，具有较好的应用前景。

Objective To discuss the clinical effect and safety of Oxaliplatin and Tegafur in treating advanced gastric cancer. Methods 126 patients of advanced gastric cancer admitted to Affiliated Hospital of Jining Medical College from October 2010 to October 2011 were divided into the observation group （64 cases） and control group （62 cases）. The observation group received the treatment of both Oxaliplatin and Tegafur （intravenously infuse the Oxaliplatin at 130 mg/m^2 for 2 hours for the first day, orally take the Tegafur at 40 mg/m^2 after the meals for two times each day from the first to the 14th day, and a course of treatment consisted of 21 days）. The control group was treated with 5-Fluorouracil, Oxaliplatin and leucovorin （intravenously infuse the 5-Fluorouracil at 400 mg/m2, Oxaliplatin at 130 mg/m^2 for 2 hours, and Leucovorin at 200 mg/m^2 for the first day; infuse the 5-Fluorouracil at 600 mg/m^2 intravenously and continuously for 24 hours for the second day, and a course of treatment consisted of 14 days）. Results and side reactions among both groups were observed. Results RR and DCR was 42.19% and 62.50% for the observation group, and 35.48% and 54.84% for the control group. It was statistically insignificant to compare results between both groups （P 〉 0.05）. The clinical benefit rate was 67.19% for the observation group, which was visibly higher than 41.94% of the control group （P 〈 0.05）. The incidence of nausea and vomiting was 10.94% for the observation group, which was visibly lower than 79.03% of the control group （P 〈 0.05）. It was statistically insignificant to compare other side reactions between both groups （P 〉 0.05）. CD4^＋ and CD4^＋/CD8^＋ improved enormously after two courses of chemical treatment for both groups （P 〈 0.05）, and these measurements in the observation group were higher than the control group （P 〈 0.05）. The TTP was 8.42 months for the observation group, which was visibly longer than 4.65 months of the control group （P 〈 0.05）. It was statistically insignificant to compare MST between both groups （P 〉 0.05）. Conclusion While Oxaliplatin and Tegafur are used together to treat advanced gastric cancer, the approach can slow down the advancement of the disease, achieve high clinical benefits, slight side effects and great tolerance among patients. Moreover, it is able to improve the cellular immunity of patients. Thus, it has a bright prospect for application.