TCF和FOLFIRI方案二线治疗进展期胃癌的疗效及安全性

Efficacy and safety of TCF and FOLFIRI regimens as second-line treatment for advanced gastric cancer

目的探讨氟尿嘧啶联合奥沙利铂化疗失败后多西他赛联合氟尿嘧啶及顺铂(TCF)方案和伊立替康联合氟尿嘧啶及亚叶酸钙(FOLFIRI)方案二线治疗进展期胃癌的疗效。方法选取2013年1月至2014年12月住院治疗患者62例,且均经病理明确诊断为胃癌,一线化疗(FOLFOX、SOX、XELOX)后进展,分为TCF组32例,FOLFIRI组30例,观察两组疗效及不良反应发生情况。结果 TCF组临床有效率与控制率分别为12. 5%、59. 3%,FOLFIRI组分别为10. 0%、60. 0%,两组比较无统计学差异(P>0. 05)。两组中位无疾病进展时间(PFS)分别为3. 2个月和3. 1个月,中位生存期(OS)分别为5. 8个月和5. 3个月,两组PFS、OS比较差异均无统计学意义(P>0. 05)。两组白细胞减少、血小板减少、恶心呕吐、乏力、肝功能损害比较,无统计学差异(P>0. 05); TCF组腹泻、胆碱能综合征发生率明显低于FOLFIRI组(P<0. 05),口腔黏膜炎发生率明显高于FOLFIRI组(P<0. 05)。结论对氟尿嘧啶及奥沙利铂化疗失败后的进展期胃癌患者行TCF或FOLFIRI方案二线化疗疗效相近,不良反应有差异。

Objective To explore the efficacy of second-line treatment chemotherapy regimens TCF( Docetaxel combined with fluorouracil and cisplatin) and FOLFIRI( rinotecan combined with fluorouracil and calcium leucovorin) after failure of chemotherapy of fluorouracil combined with oxaliplatin for the treatment of advanced gastric cancer. Methods A total of 62 hospitalized patients from January 2013 to December 2014 who were definitely diagnosed as gastric cancer by pathologically and were progression after first-line chemotherapy( FOLFOX,SOX,XELOX) were selected. The patients were divided into TCF group( n = 32) and FOLFIRI group( n = 30) by randomized allocation. Efficacy and adverse reactions in two groups were observed. Results There were no significant differences in clinical effective rate and control rate between TCF group and FOLFIRI group( 12.5% vs 10.0%; 59.3% vs 60.0%; all P > 0.05). There were no significant differences in median progression free time( PFS) and median overall survival( OS) between TCF group and FOLFIRI group( 3.2 months vs 3. 1 months; 5.8 months vs 5.3 months; all P > 0.05). There were no significant differences in leukopenia,thrombocytopenia,hemoglobin decrease,nausea,vomiting,fatigue and liver function damage between two groups( all P>0.05). The incidences of diarrhea and cholinergic syndrome in TCF group were significantly lower than those in FOLFIRI group( all P < 0.05),and the incidence of oral mucositis in TCF group were significantly higher than that in FOLFIRI group( P<0.05). Conclusion After failure of chemotherapy of fluorouracil combined with oxaliplatin,the efficacy of TCF and FOLFIRI second-line chemotherapy regimens is similar,but their adverse reactions were different.