雷替曲塞联合槐耳颗粒二线治疗晚期胃癌临床观察

Raltitrexed combined huaier granule as second-line treatment in advanced gastric cancer

目的探讨雷替曲塞联合槐耳颗粒二线治疗晚期胃癌的疗效与安全性。方法回顾性分析2014年1月至2015年12月收治的二线给予雷替曲塞联合槐耳颗粒治疗的21例患者临床资料。治疗方法为第1天雷替曲塞3 mg/m^2静脉滴注;第1天至第21天槐耳颗粒20 g,每日3次口服,21 d为1周期。每周期评价不良反应,直至疾病进展或出现无法耐受的不良反应。每2个周期评价疗效,随访患者的生存状况。结果 21例患者共完成114周期化疗,平均5.4周期。所有患者均可评价疗效。其中,部分缓解(PR)3例,疾病稳定(SD)10例,疾病进展(PD)8例,有效率(RR)为14.3%,疾病控制率(DCR)为61.9%。中位无进展生存期3.1个月,中位总生存期5.2个月,无治疗相关性死亡。不良反应主要为血液学毒性,其中,中性粒细胞减少5例(23.8%),血红蛋白减少3例(14.2%),粒细胞缺乏性发热1例(4.8%)。结论雷替曲塞联合槐耳颗粒治疗晚期胃癌疗效较好,且耐受性良好。

Objective To investigate the efficacy and safety of raltitrexed combined with huaier granule as second-line treatment in advanced gastric cancer. Methods A retrospective study was performed on 21 patients with advanced gastric cancer who received raltitrexed combined with huaier granule as second-line treatment from January 2014 to December 2015. Raltitrexed was given by intravenous drip in 3 mg / m^2（ first day）,huaier granule was given by oral with 20 g,three times a day（ from the first day to the twenty-first day）,twenty-one days as a cycle. The adverse reactions were evaluated every cycle until progression of disease or adverse reaction which cannot be tolerated. The short-term response was evaluated every two cycles. The patients were followed up,and the survival status was analyzed. Results Twenty-one patients received 114 cycles chemotherapy,in average 5. 4 cycles. All the patients were evaluable for response. There were 3 cases of partial response（ PR）,10 cases of stable disease（ SD） and 8 cases of progressive disease（ PD）. The response rate（ RR） was 14. 3% and disease control rate（ DCR） was 61. 9%. The median PFS was 3. 1 months,the median overall survival（ OS） was 5. 2 months. There was no treatment related death. The major side effects were myelosuppression. There were 5 cases（ 23. 8%） of neutropenia,3 cases（ 14. 2%） of anemia,1 case（ 4. 8%） of lack of granulocyte fever. Conclusion Raltitrexed combined huaier granule as second-line chemotherapy treatment in advanced gastric cancer showed good effect and tolerance.