mEOF方案与mFOLFOX6方案治疗晚期胃癌的疗效比较

Clinical observation of modified EOF and modified FOLFOX6 regimen in the treatment of advanced gastric cancer

目的:观察和比较mEOF方案(表阿霉素+奥沙利铂+5-氟尿嘧啶)与mFOLFOX6方案(奥沙利铂+5-氟尿嘧啶+亚叶酸钙)治疗晚期胃癌的临床疗效、毒副反应、平均住院时间及花费。方法:回顾性分析38例接受mEOF(16例)和mFOLFOX6(22例)方案化疗的晚期胃癌患者,每2个化疗周期后采用RECIST1.1标准进行疗效评价,每个化疗周期根据NCI-CTC3.0标准记录毒副反应,每个化疗周期的住院时间及花费从本院的医疗系统(HIS)中采集。结果:mEOF组CR0例,PR1例,SD9例,PD6例,RR为6.3%,DCR为62.5%,中位PFS为2.2个月;mFOLFOX6组CR0例,PR2例,SD13例,PD4例,RR为10.5%,DCR为78.9%,中位PFS为5.2个月,两组疗效差异无统计学意义;在对患者的生活质量影响上,mFOLFOX6方案能更好的改善患者的生活质量(P=0.014);主要毒副反应为骨髓抑制、胃肠道反应,以Ⅰ/Ⅱ度为主,其中,mFOLFOX6组白细胞减少发生率显著高于mEOF组(P=0.009);mEOF组血小板减少发生率显著高于mFOLFOX6组(P=0.019)。在住院时间及花费方面,mEOF组平均住院时间及费用都明显低于mFOLFOX6组(P=0.00)。结论:mEOF方案和mFOLFOX6方案治疗晚期胃癌疗效相近,毒副反应可耐受,mFOLFOX6方案在改善患者的生活质量方面有优势,mEOF组平均住院时间及费用低于mFOLFOX6组。

Objective:To evaluate the efficacy,side effects,the average hospitalization time and cost of modified EOF (epirubicin+oxaliplatin+5-fluorouracil) and modified FOLFOX6(oxaliplati+5-fluorouracil+leucovorin) regimens in the treatment of advanced gastric cancer(AGC). Methods:In a retrospective study,38 patients with AGC who recived the regimen of mEOF(16 cases) or mFOLFOX6(22 cases) were analyzed.The efficacy was evaluated every two cycles according to RECIST1.1 criteria,and the side effects were evaluated every cycle according to the NCI-CTC 3.0.The average hospitalization time and cost were collected from the HIS medical system of our hospital. Results:The efficacy of three cases of mFOLFOX6 can' t be evaluated,others could be evaluated.In the mEOF group:CR 0 case,PR1 case,SD 9 cases,PD 6 cases.The response rate(RR) was 6.3%,disease control rate(DCR) was 62.5%,and the median progression free survival(PFS) was2.2 months.In the mFOLFOX6 group:CR 0 case,PR2cases,SD13 cases,PD 4 cases.RR was10.5%,DCR was 78.9%,and the median PFS was 5.2 months.RR,DCR and PFS were not significantly different between two groups.On the impact of quality of life on patients,mFOLFOX6 program can better improve the quality of life of patients( P =0.014).The main toxicities were myelosuppression and gastrointestinal reaction in both groups,mainly in grade Ⅰ/Ⅱ.The incidence of leucopenia in the mFOLFOX6 group was significantly higher than that in the mEOF group( P =0.009).The incidence of thrombocytopenia in the mEOF group was significantly higher than that in the mFOLFOX6 group( P =0.019).The average hospitalization time and cost in the mEOF group were significantly lower than that in the mFOLFOX6 group. Conclusion:The efficacy of mEOF and mFOLFOX6 regimens in the treatment of advanced gastric cancer is similar.The side effects can be well-tolerated.The mFOLFOX6 regimen can better improve the quality of life of patients.The average hospitalization time and cost in the mEOF group were lower than that in the mFOLFOX6 group.