S-1联合DDP腹腔循环热灌注治疗老年胃癌合并腹水临床疗效观察

Therapeutic effects of S-1 combined with DDP circulatory thermochemotherapy of intraperitoneal perfusion for the elderly advanced gastric carcinoma patients with ascites

目的:观察替吉奥联合顺铂腹腔恒温循环热灌注治疗老年胃癌合并腹水的疗效和安全性。方法:47例患者口服替吉奥40-60mg/次,每天2次,d1-14,停药7d;顺铂90mg d1,60mg d8,均21d为1周期,2周期后行疗效评价,按照WHO标准评价客观疗效和不良反应。结果:47例患者均可进行客观疗效及安全性评价,CR 3例,PR 27例,NC 10例,PD 7例,腹水有效控制率(CR+PR)为63.8%(30/47)。m PFS为6.2个月,m OS为10.7个月。临床受益反应为80.9%(38/47)。不良反应主要为血液学毒性、胃肠道反应。Ⅲ-Ⅳ度贫血、白细胞减少、呕吐发生率分别为13例(27.7%)、10例(21.3%)、9例(19.1%)。结论:替吉奥联合DDP腹腔循环热灌注方法治疗老年胃癌合并腹水近期疗效较好,不良反应可以耐受,值得进一步研究应用。

Objective： To observe the therapeutic effects and adverse effects of S- 1 combined with DDP by circulatory thermochemotherapy of intraperitoneal perfusion for the elderly patients with advanced gastric carcinoma with ascites. Methods： All 47 patients assigned to S- 1 plus cisplatin,S- 1（ 40- 60 mg depending on patient＇s body area）was given orally,twice daily for 2 weeks,drug withdrawl for 1 week. At the same time,90 mg DDP was given on the first day and 60 mg DDP on the eighth day respectively by circulatory thermochemotherapy instrument. Twenty one days as a cycle,2 cycles totally. The efficacy and adverse effects were evaluated according to the common toxicity criteria of WHO. Results： All 47 patients were evaluated for clinical and toxicity. CR 3 cases,PR 27 cases,NC 10 cases,PD 7 cases. The objective response rate（ CR ＋ PR） was 63. 8%（ 30 /47）. The median progress free survival（ m PFS）was 6. 2 months,the median overall survival（ m OS） was 10. 7 months. The clinical benefit response was 80. 9%（ 38 /47）. There was grade Ⅲ- Ⅳ WHO toxicity of anemia in 13 patients（ 27. 7%）,leukocytes in 10 patients（ 21. 3%）,vomiting in 9 patients（ 19. 1%）. Conclusion： The treatment of S- 1 combined with DDP by circulatory thermochemotherapy of intraperitoneal perfusion for elderly patients with advanced gastric carcinoma with ascites is effective and tolerable. It is worthy of studying further in clinic.