每周脂质体紫杉醇或奥沙利铂联合替吉奥方案治疗老年晚期胃癌的疗效及安全性分析

Efficacy and Safety of Weekly Liposome-paclitaxel or Oxaliplatin Combined with Tegafur on Elderly Advanced Gastric Cancer

目的比较每周脂质体紫杉醇联合替吉奥与奥沙利铂联合替吉奥一线治疗老年晚期胃癌的疗效及安全性。方法将119例老年晚期胃癌患者随机分为两组,A组62例患者采用每周脂质体紫杉醇联合替吉奥方案,B组57例患者采用奥沙利铂联合替吉奥方案。比较两组患者的近期疗效、无疾病进展时间（PFS）、总生存时间（OS）、体能状态和不良反应。结果 A组患者的客观缓解率（ORR）、疾病控制率（DCR）、PFS、OS分别为22.0%、69.5%、6.4月和10.8月,B组分别为25.0%、67.9%、6.4月和10.4月,两组间差异均无统计学意义（P均〉0.05）。B组Ⅰ~Ⅱ级胃肠道反应、Ⅰ~Ⅱ级和Ⅲ~Ⅳ级外周神经毒性发生率均较A组严重（P均〈0.05）。结论每周脂质体紫杉醇联合替吉奥治疗老年晚期胃癌的近期疗效与传统的奥沙利铂联合替吉奥相似,但前者患者的耐受性更好,可推荐作为老年晚期胃癌患者治疗的首要选择。

Objective To explore the efficacy and safety of weekly liposome-paclitaxel versus oxaliplatin with tegafur（S-1） as the first-line therapy on elderly advanced gastric cancer patients. Methods A total of 119 elderly patients with advanced gastric cancer were randomly divided into Group A（62 cases） and Group B（57 cases）. In Group A, liposome-paclitaxel combined with S-1 was administered; in Group B, oxaliplatin combined with S-1 was applied. The short-term efficacy, median progression free survival（PFS）, median overall survival（OS）, Karnofsky performance status score and adverse reactions of the two groups were observed and compared. Results No significant difference was observed in the objective response rate（ORR）, disease control rate（DCR）, median PFS and median OS between Group A and Group B（22.0% vs. 25.0%, 69.5% vs. 67.9%, 6.4 vs. 6.4 months, 10.8 vs. 10.4 months; all P0.05）. The incidence of degrees Ⅰ-Ⅱ nausea and vomiting and peripheral nerve toxicity were significantly higher in Group B than those in Group A（all P0.05）. Conclusion The short-term efficacy of weekly liposome-paclitaxel combined with S-1 treatment was same with oxaliplatin combined with S-1 treatment, and the former treatment has a tendency of lower toxicity and could be recommended as the optimal treatment for the elderly advanced gastric cancer patients.