奥沙利铂和卡培他滨联合或不联合多西他赛治疗晚期胃癌的疗效

Efficacy of oxaliplatin and capecitabine combined with or without docetaxel for advanced gastric cancer

目的探讨多西他赛、奥沙利铂联合卡培他滨(DOX方案)与单纯奥沙利铂联合卡培他滨(XELOX方案)治疗晚期胃癌的临床疗效和不良反应。方法选取2010年1月至2013年1月间秦皇岛市第四医院收治的82例晚期胃癌患者,根据化疗方案分为DOX组和XELOX组,DOX组50例,XELOX组32例。DOX组患者采用奥沙利铂与卡培他滨联合多西他赛方案化疗;XELOX组患者采用奥沙利铂联合卡培他滨方案化疗。每化疗2周期后进行疗效评价,且每周期观察并记录不良反应,评价两组患者有效率(RR)、疾病控制率(DCR)和中位无进展生存期(PFS)。结果 DOX组患者中,完全缓解(CR)2例(4.0%),部分缓解(PR)24例(48.0%),病变稳定(SD)20例(40.0%),有效率(RR)为52.0%,DCR为92.0%,PFS为4.8个月。XELOX组患者中,CR 0例,PR 10例(31.3%),SD 17例(53.1%),RR为31.3%,DCR为84.4%,PFS为4.2个月。两组患者的总有效率、疾病控制率和中位无进展生存期差异均无统计学意义(均P>0.05)。化疗导致的主要不良反应为骨髓抑制、胃肠道反应、脱发和周围神经病变等,患者均可而授。结论 DOX和XELOX化疗方案治疗进展期胃癌疗效相近,不良反应均可耐受。

Objective To evaluate the efficacy and safety of docetaxel and oxaliplatin combined with capecitabine（ DOX） and oxaliplatin combined with capecitabine（ XELOX） for the advanced gastric cancer. Methods Retrospectively analyzed 82 patients with advanced gastric cancer who treated at The Fourth Hospital of Qinhuangdao City from January 2010 to January 2013. The patients were divided into DOX group（ 50 patients） and XELOX group（ 32 patients） according to the regimen received. The efficacy and toxicity were evaluated after at least two consecutive courses. Responserate（ RR）,disease control rate（ DCR） and progression-free survival（ PFS） were evaluated. Results All patients were evaluated for efficacy and safety. In the DOX group,complete response（ CR） was observed in 2 patients（ 4. 0%）. Partial response（ PR） was observed in 24 patients（ 48. 0%）. Steady disese（ SD） was observed in 20 patients（ 40. 0%）. The RR was 52. 0%,DCR was 92. 0%,and the median PFS was 4. 8 months. In the SOX group,no patient was found with CR,PR was found in 10 patients（ 31. 3%） and SD was found in 17 patients（ 53. 1%）. RR was 31. 3%,DCR was 84. 4%,and the median PFS was 4. 2 months. There was no significant difference in RR,DCR and the median PFS between the two groups（ all P〉0. 05）. The main adverse effects caused by chemotherapy included bone marrow arrest,gastrointestinal reaction,alopecia and peripheral neuropathy. There were significantly more alopecia in the DOX group than in the XELOX group（ P〈0. 05）. There was no statistical difference in other adverse reactions（ all P〉0. 05）. Conclusion The efficacy of DOX is similar with that of XELOX with well-tolerable adverse effects for advanced gastric cancer.