塞来昔布联合化疗治疗晚期胃癌的疗效分析

Efficacy of celecoxib combined with chemotherapy in the treatment of advanced gastric cancer

目的观察选择性环氧合酶2(cylooxygenase-2,COX-2)抑制剂塞来昔布联合多西他赛和替吉奥方案治疗晚期胃癌的临床疗效和不良反应。方法将50例晚期胃癌患者随机分为两组,试验组25例采用塞来昔布联合多西他赛和替吉奥方案化疗,对照组25例给予单纯多西他赛和替吉奥方案化疗,2个周期治疗后评估两组近期疗效和不良反应,同时观察生存情况。结果完成2个周期治疗后,试验组有效率为60%,疾病控制率为96%,对照组分别为52%和92%,两组比较差异均无统计学意义(P>0.05);两组治疗后不良反应发生率差异亦无统计学意义(P>0.05);试验组生活质量改善率高于对照组,差异有统计学意义(60%vs 32%,P<0.05)。试验组和对照组中位无疾病进展生存期差异亦有统计学意义(7.6个月vs 6.3个月,P<0.05);但中位总生存期差异无统计学意义(13.6个月vs 12.2个月,P>0.05)。结论塞来昔布联合多西他赛和替吉奥治疗晚期胃癌与单用化疗疗效相当,无疾病进展生存期延长,可改善生活质量且不增加不良反应。

Objective To evaluate the therapeutic efficacy and toxicity of celecoxib plus docetaxel and S-1 in the treatment of advanced gastric cancer. Methods Fifty patients with advanced gastric cancer were randomly divided into two groups,which were treated with celecoxib（Celebrex） plus docetaxel and S-1（n=25）,or with docetaxel and S-1（n =25） as the control arm. Results After treatment,the total effective rate and disease control rate were 60% and 96% in the treatment group,compared to 52% and 92%in the control group.The groups were similar in terms of total effective rate and disease control rate（P〉0.05）.Toxicity after treatment was minor in the two groups,and incidences of toxic events were similar between the two groups（P〉0.05）.Improvement in quality of life was significantly higher in the treatment group than in the control group（60% vs 32%,P〈0.05）.Median PFS was 7.6 months in the treatment group,which was significantly higher than 6.3 months in the control group（P 〈0.05）.Median overall survival was 13.6 months in the treatment group and 12.2 months in the control group（P 〉0.05）. Conclusions Celecoxib plus docetaxel and S-1 for advanced gastric cancer is superior to chemotherapy alone,and it can prolong PFS and improve quality of life without increasing adverse reactions.