替吉奥、奥沙利铂、多西他赛联合化疗在治疗姑息切除胃癌中的意义

Palliative surgery combined with S-1,oxaliplatin and docetaxel chemotherapy in treatment of patients with advanced gastric cancer

目的：分析姑息切除胃癌术后替吉奥联合奥沙利铂、多西他赛化疗的病例资料，以了解该疗法的安全性及疗效。方法：收集2010年－2011年在吉林大学中日联谊医院资料完整的姑息切除胃癌患者20例。术后第20～30天开始联合奥沙利铂、多西他赛及替吉奥化疗（研究组），用药方案如下：奥沙利铂135mg／m^2静脉滴注，多西他赛75mg／m^2静脉滴注，替吉奥40mg／m^2，2次／日，连续口服14天停药7天。每21天一疗程，实施3个疗程后评价化疗效果。无效病例中断化疗；有效病例继续用6～8个疗程，并与应用FOLFOX化疗方案（对照组）患者24例进行随机对照研究。结果：研究组20例患者均可评价疗效，其中1例完全缓解（CR），6例部分缓解（PR），9例稳定（SD），4例进展（PD），总有效率（CR＋PR）为35％，疾病控制率为80％。主要不良反应为胃肠道反应、白细胞减少和周围神经毒性，均较轻，未影响治疗。两组不良反应对比无明显差异，生存时间具有显著性差异。结论：替吉奥胶囊联合奥沙利铂及多西他赛化疗治疗姑息切除胃癌的近期疗效较好，不良反应可以耐受，且治疗效果优于FOLFOX化疗方案。

Objective：To analyze the safety and effect of the palliative surgery combined with S - 1 ,oxaliplatin and docetaxel chemotherapy in treatment of patients with advanced gastric cancer. Methods： A total of 20 patients un- derwent palliative resection of gastric cancer in China - Japan Union Hospital of Jilin University from 2010 to 2011 were evaluated. Chemotheraphy was given 20 - 30 days postoperative with oxaliplatin （ 135mg/m^2 intravenous injec- tion） ,docetaxel（75mg/m^2 intravenous injection） and S- 1 （40mg/m^2 ,2 times/day orally for 14 days off 7 days）. The cycle was repeated every 21 days. Evaluation was performed 3 cycles after chemotherapy, invalid cases were ter- minated the chemotherapy, effective cases continue to 6 ～ 8 cycles of the treatment for further analysis. Results： All of the 20 cases could be evaluated,complete response （CR） occurred in 1 case,partial response （PR） in 6 cases,9 ca- ses with stable disease （SD） ,4 patients with progressive disease （PD）, the total efficiency was 35% （CR ＋ PR）, dis- ease control rate was 80%. The main adverse reactions were gastrointestinal reaction, reduction in white blood cells and peripheral neurotoxicity. The reactions were relatively light, no influence to the treatment. There was no significant difference between two groups in adverse reaction. The survival time was longer than the group which used FOLFOX. Conclusion：S - 1 combined with oxaliplatin and docetaxel chemotherapy in the treatment of palliative resection of gastric cancer has a good therapeutic effect, adverse reactions can be tolerated.