奥沙利铂联合表阿霉素与卡培他滨一线治疗晚期胃癌的临床观察

Clinical observation of oxaliplatin,epirubicin combined with capecitabine in first line treatment of advanced gastric cancer

目的：评价奥沙利铂联合表阿霉素与卡培他滨一线治疗晚期胃癌的有效性与安全性。方法晚期胃癌32例，奥沙利铂100 mg· m-2，静脉滴注2 h，第1天；表阿霉素50mg· m-2，静脉滴注10～15 min，第1天；卡培他滨1250 mg· m-2，分2次口服，连服14 d，21 d为1个周期。化疗每2周期后评价疗效和不良反应。结果2例因不能耐受化疗仅接受1个周期治疗未能评价疗效，30例可评价患者中完全缓解（CR）1例，部分缓解（PR）10例，疾病稳定（SD）13例，疾病进展（PD）6例。客观缓解率为（CR＋PR）36．66％，疾病控制率为（CR＋PR＋SD）80％。主要不良反应为中性粒细胞减少、末梢神经炎和恶心呕吐，无治疗相关性死亡。结论奥沙利铂联合表阿霉素与卡培他滨一线治疗晚期胃癌，近期疗效较好，不良反应可耐受，值得临床进一步探索。

Objective To evaluate the effectiveness and safety of oxaliplatin ,epirubicin combined with capecitabine in the first treat-ment of advanced gastric cancer .Methods Thirty-two patients with advanced gastric cancer were treated with oxaliplatin 100 mg· m-2 intravenous drip for 2 hours day 1,epirubicin 50 mg· m-2 intravenous drip for 10-15 minutes day 1,capecitabine 1 250 mg· m-2 orally taken twice a day from day 1 to day 14.The efficacy and side effects were evaluated after two cycles of chemotherapy .Re-sults Two patients were not assessed for efficacy because of intolerance chemotherapy and only one treatment cycle .In the 30 evalu-able cases,complete remission ratio（CR）,partial response ratio（PR）,stable disease（SD） and progressive disease（PD） were observed in 1 case,10 cases,13 cases and 1 case,respectively.The objective response rate（CR＋PR） and disease control rate（CR＋PR＋SD） were 36.66%and 80%,respectively.The side effects were neutropenia peripheral neuritis ,nausea and vomiting.There were no treat-ment-related deaths.Conclusions Oxaliplatin,epirubicin combined with capecitabine in first line treatment of advanced gastric cancer can achieve better short-term efficacy and tolerated side effects .This combination strategy thus deserves further examination in clinic .