替吉奥联合同步放疗治疗晚期胃癌的疗效及安全性分析

Efficacy and Safety of S-1 Combined with Concurrent Radiotherapy for Advanced Gastric Cancer

目的探讨替吉奥联合同步放疗治疗晚期胃癌的疗效及安全性。方法分析晚期胃癌患者98例,编号后随机分为A组(33例)、B组(33例)和C组(32例)。A组给予替吉奥单药治疗,B组给予替吉奥联合同步放疗治疗,C组采用ECF方案进行治疗。在治疗3个周期后,依照RECIST 1.0标准评价治疗效果。结果 98例患者均完成3个周期的治疗,B组CR率(12.12%)和PR(45.45%)率较高,RR率显著高于A组(36.36%)和C组(28.13%)(P<0.05),B组治疗方案具有一定的临床优越性。B组可行胃癌根治术患者达45.45%,显著高于A组(21.21%)和C组(9.38%)。与A组比较,B组发生恶心呕吐和肢端麻木不良反应发生率较高(P<0.05);与C组比较,B组恶心呕吐和肢端麻木不良反应发生率较低(P<0.05);B组患者Ⅲ、Ⅳ级不良反应发生率较低。B组患者治疗后12个月生存率最高,而C组最低。结论替吉奥联合同步放疗对晚期胃癌患者有较好的临床治疗效果且患者耐受性好,可以提高临床胃癌根治术的适用范围并延长患者的生存期。

Objective To explore the therapeutic effect and safety of S-1 combined with concurrent radiotherapy for advanced gastric cancer.Methods 98 patients with advanced gastric cancer were selected and randomly divided into group A with33 cases,group B with 33 cases and group C with 32 cases.Patients in group A were given S-1 only,group B were given S-1 combined with concurrent radiotherapy,while group C were given ECF regimen.After 3 cycles of treatment,therapeutic effect was analyzed according to RECIST1.0.Results 98 patients with advanced gastric cancer had completed 3 cycles of treatments.Patients in group B had higher rates of CR（12.12%） and PR（45.45%）,and higher rate of RR compared with group A（36.36%） and group C（28.13%）（P〈0.05）.Group B regimen had some clinical application superiority.The radical operation rate in group B was 45.45%,which was apparently higher than group A（21.21%） and group C（9.38%）.Compared with group A,group B had higher incidences of nausea and vomiting（P〈0.05）,acroanesthesia（P〈0.05）.But group B had lower incidences of nausea and vomiting（P〈0.05）,acroanesthesia（P〈0.05） compared with group C.Ⅲ to Ⅳ levels of adverse reactions in group B were low incidence.12-month survival rate of group B were the highest,and group C were the lowest.Conclusion S-1 combined with concurrent radiotherapy for advanced gastric cancer is effective and well tolerated.It may increase application scope of radical operation and prolong patient’s survival time.