热疗联合替吉奥治疗老年晚期胃癌的临床疗效

Clinical effects of hyperthermia combined with S-1 chemotherapy in elderly patients with advanced gastric cancer

目的:评价替吉奥胶囊(S-1)联合热疗治疗老年晚期胃癌的临床疗效及不良反应,旨在为65岁以上的老年晚期胃癌患者寻找有效、不良反应轻的治疗方式.方法:选择2010-02/2012-09的石河子大学医学院第一附属医院的老年胃癌晚期患者(年龄≥65岁)90例,采用随机对照研究将90例患者随机分为3组.A组给予替吉奥胶囊单药化疗,B组给予替吉奥联合热疗,C组给予卡培他滨联合热疗,治疗时间超过两周期,观察近期、远期疗效以及不良反应,进行统计学分析.结果:A、B、C组临床获益率分别是50%、80%,70%,B组较A组临床获益率高(P<0.05),与C组差异无统计学意义(P>0.05).远期疗效评价:B组、C组中位无进展生存时间(6.6、5.8 m o)较A组(3.8 m o)有所延长(P<0.05).替吉奥较卡培他滨化疗不良反应轻,主要是乏力、腹泻、手足综合症反应较轻,差异有统计学意义(P<0.05).结论:替吉奥联合热疗或卡培他滨联合化疗治疗老年晚期胃癌比替吉奥单药疗效好,替吉奥联合热疗与卡培他滨联合热疗疗效无差异,但替吉奥较卡培他滨不良反应轻,老年患者耐受性好.

AIM：To evaluate the clinical effects of gimeracil and oteracil porassium tablet（S-1） combined with hyperthermia in the treatment of elderly patients with advanced gastric cancer.METHODS：Ninety elderly gastric cancer patients treated from February 2010 to September 2012 were randomly divided into three groups：A,B and C.Group A received S-1 chemotherapy alone,group B was given S-1 combined with hyperthermia,and group C was given capecitabine combined with hyperthermia.After more than two cycles of treatment,the short-term and long-term curative effects and adverse reactions were analyzed.RESULTS：The clinical benefit rate in group B was significantly higher than that in group A（80%vs 50%,P〈0.05）,but was not significantly different with that in group C（70%,P〉0.05）.Compared with group A（3.8 mo）,median progression-free survival times in groups B（6.6mo） and C（5.8 mo） were significantly prolonged（P〈0.05）.Compared with capedtabine,S-l was associated with significantly milder toxicity such as fatigue,diarrhea,and hand-foot syndrome（P〈0.05）.CONCLUSION：Compared with S-l chemotherapy alone,capecitabine or S1 combined with hyperthermia therapy has a better therapeutic effect in the treatment of elderly patients with advanced gastric cancer.The efficacy between S-l combined with hyperthermia and capecitabine combined with hyperthermia has no difference.Compared with capecitabine,S-l has less toxic side effects and is well tolerated in elderly patients.