雷替曲塞联合奥沙利铂二线治疗晚期贲门癌的疗效观察

Effect of raltitrexed combined oxaliplantin as second-line chemotherapy for advanced gastric cardial carcinoma

目的雷替曲塞与奥沙利铂联合方案二线治疗晚期贲门癌的近期疗效和不良反应。方法对58例经过一线化疗之后出现复发进展的晚期贲门癌患者采用雷替曲塞联合奥沙利铂方案化疗,雷替曲塞3mg/m2静脉滴注联合奥沙利钠130mg/m2静脉滴注,时间>3h,均为第1天给药,每21d为1周期,2周期后行胸腹部CT评价疗效,并评价不良反应,最多6个周期。结果 58例患者完全缓解2例(3.4%),部分缓解16例(27.6%),稳定14例(24.1%),疾病进展26例(44.8%);总有效率为31.0%,临床获益率为55.2%。中位疾病进展时间6.9个月,主要不良反应为骨髓抑制、恶心呕吐、转氨酶升高、周围神经毒性等,多为轻度,无治疗相关性死亡患者,也无因毒性反应而推迟化疗者。结论雷替曲塞联合奥沙利铂二线治疗复发转移的晚期贲门癌具有较好的疗效,耐受性好。

Objective To evaluate the efficiency and toxicity of raltitrexed combined qxaliplantin as second-line chemotherapy in treatment of advanced gastric cardial carcinoma.Methods Fifty-eight patients of advanced gastric cardial carcinoma who had received first-line therapy but had relapsed or progressed were given 3 mg/m2 of raltitrexed,intravenous bolus,d1,21 days as a cycle,combined oxaliplantin 130 mg/m2,intravenous infusion〉3h,d1,21 days as a cycle.The analysis lasted at least two cycles so as to evaluate the short-term efficiency and adverse reactions.After two cycles of chemotherapy,the efficiency and toxicity were evaluated.A total of six cycles were applied unless there were evidence of disease progression or intolerance of treatment.Results All 58 patients were evaluable,including complete response 2cases,accounting for 3.4%,partial response 16 cases,accounting for 27.6%;stable disease 14 cases,accounting for 24.1%;progressive disease 26 cases,44.8%.Overall response rate was31.0%,disease control rate 55.2%,the middle time to progression 6.9months.The main side effects were myelosuppression, gastrointestinal reactions,aminotransferase abnormality,peripheral neurotoxicity and so on.The whole group had no treatment-related death in patients and no toxicity due to the delay chemotherapy.Conclusion Raltitrexed as second-line chemotherapy in treatment of advanced gastric cardial carcinoma is effective and well tolerated.