替吉奥联合紫杉醇周疗对晚期老年胃癌患者的临床疗效评价

Clinical evaluation of S-1 capsule combined with weekly Paclitaxel on elderly patients with advanced gastric cancer

目的 评价替吉奥（S-1）联合紫杉醇周疗治疗晚期老年胃癌患者的近期疗效及毒副反应物.方法 将广西横县人民医院确诊的38例晚期老年胃癌患者随机分为2组,治疗组20例,采用紫杉醇联合替吉奥化疗：紫杉醇60 mg/m2,第1、8、15 d用药,替吉奥胶囊80 mg/m2,2次/d,连续口服14 d,28 d为1个周期;对照组18例,采用FP方案：顺铂15 mg/m2,第1～5天静点,5-Fu 750mg/m2,第1～5天静点,28 d为1个周期.两组患者至少治疗2个周期后评价其疗效及毒副反应.结果 治疗组与对照组的有效率（RR）、疾病控制率（DCR）、1年生存率分别为40.0％、75.0％、55.0％和22.2％、50.0％、38.9％,差异无统计学意义（P＞0.05）;治疗组患者KPS改善情况优于对照组（P＜0.05）;治疗组的胃肠道反应及Ⅲ～Ⅳ度骨髓抑制明显低于对照组（P＜0.05）.结论 替吉奥口服联合紫杉醇周疗方案化疗有效率高,老年患者耐受性好,是老年晚期胃癌患者值得选择的化疗方案.

Objective To evaluate the efficacy and toxicity of S-1 capsule combined with weekly Paclitaxel on elder- ly patients with advanced gastric cancer. Methods Thirty-eight etderly patients of gastric cancer diagnosed in People＇ s Hospital of Heng County were randomly divided into two groups. Treatment group of 20 patients were received Paclitaxel combined with S-1 chemotherapy （the chemotherapy included Paclitaxel 60 mg/m2 intravenously on days 1, 8, 15 and S-1 capsule 80 mg/m2 twice daily for 14 days, every 28 days repeated）. The control group of 18 patients were received FP chemotherapy （the chemotherapy included Cisplatin 15 mg/m2 intravenously every day from the first day to fifth day, Fluorouraeil 750 mg/m2 intravenously every day from first day to fifth day, every 28 days repeated）. Efficacy and toxici- ty were evaluated at least 2 cycles of treatment between two groups. Results The efficiency of the treatment group and control group were 40.0% , 22.2% , the disease control rates were 75.0% , 50.0% , the 1-year survival rates were 55.0% , 38.9% （P 〉0.05）. Quality of life of treatment group was better than that of the control group （P 〈 0. 05）. The gastrointestinal reaction and Ⅲ-Ⅳ bone marrow suppression of the treatment group were significantly lower than the control group （P 〈 0.05）. Conclusion The chemotherapy of S-1 combined with weekly Paclitaxel is efficient. Eld- erly patients could tolerate this treatment. It is valuable chemotherapy for elderly patients with advanced gastric cancer.