紫杉醇或多西他赛联合奥沙利铂或顺钳及氟尿嘧啶或替吉奥治疗中晚期胃癌的临床疗效及安全性观察

Clinical efficacy and safety of paclitaxel or docetaxel combined with oxaliplatin or cisplatin and fluorouracil or tiggio in the treatment of advanced gastric cancer

目的比较奥沙利铂联合替吉奥与紫杉醇(或多西他赛)联合奥沙利铂(或顺铂)及氟尿嘧啶方案治疗中晚期胃癌的疗效与化疗后不良反应:方法选取安徽医科大学第一附属医院肿瘤内科2015年1月至2018年4月收治的中晚期胃癌患者60例,将其按照简单随机化原则分为两组。对照组给予奥沙利铂联合替吉奥方案治疗,观察组给予紫杉醇(或多西他赛)联合奥沙利铂(或顺铂)及氟尿嘧啶方案治疗,比较两组的治疗效果[完全缓解(CR)、部分缓解(PR)、病情稳定(SD)、病情进展(PD)]和不良反应[血液毒性(白细胞减低、血小板降低、贫血)、非血液毒性(肝功能受损、恶心呕吐、口腔黏膜炎、神经毒性)]。结果观察组有效率(RR)为66.7%,与对照组RR(40.0%)比较差异有统计学意义(x^2=4.286,P <0.05),而两组血小板降低、肝功能受损、贫血、口腔黏膜炎、恶心呕吐及神经毒性等不良反应差异均无统计学意义(均P>0.05)。结论使用奥沙利铂联合替吉奥与紫杉醇(或多西他赛)联合奥沙利铂(或顺铂)及氟尿嘧啶方案治疗中晚期胃癌可提高疗效,而不增加不良反应。

Objective To compare the treatment effect and adverse reaction of oxaliplatin and tiggio and paclitaxel or docetaxel combined with oxaliplatin or cisplatin and fluorouracil or tiggio in the treatment of advanced gastric cancer.Methods From January 2015 to April 2018,60 patients with advanced gastric cancer were selected from Department of Oncology of the First Affiliated Hospital of Anhui Medical University.The patients were randomly divided into two groups according to the principle of simple randomization,with 30 cases in each group.The control group was treated with oxaliplatin+tiggio.The obseiwation group was given paclitaxel(or docetaxel)combined with oxaliplatin(or cisplatin)and fluorouracil.The incidence of adverse reactions(hematotoxicity and non-hematologic toxicity),the efficacy(CR,PR,SD,PD)of the two groups were compared.Results The RR level of the observation group was 66.7%,which was significantly higher than 40.0%of the control group(X^2=4.286,P<0.05).There were no statistically significant differences between the two groups in incidence of adverse reactions such as thrombocytopenia,impaired liver function,anemia,oral mucositis,nausea and vomiting and neurotoxicity(all P>0.05).Conclusion Treatment of advanced gastric cancer with FLOT or DCF can improve efficacy without increasing side effects.