曲妥珠单抗联合不同化疗方案治疗人表皮生长因子受体-2阳性晚期胃癌患者的回顾性研究

Clinical efficacy of trastuzumab combined with different chemotherapies in patients with human epidermal growth factor receptor-2 positive advanced gastric cancer:A retrospective study

目的对比分析曲妥珠单抗联合卡培他滨加奥沙利铂(XELOX)方案与曲妥珠单抗联合替吉奥加奥沙利铂(SOX)方案治疗人表皮生长因子受体-2(Her-2)阳性晚期胃癌的疗效和不良反应。方法将曾经以曲妥珠单抗联合XELOX或曲妥珠单抗联合SOX作为一线化疗方案进行治疗的患者(n=40)分别纳入曲妥珠单抗-XELOX组(n=21)或曲妥珠单抗-SOX组(n=19)。曲妥珠单抗-XELOX组、曲妥珠单抗-SOX组的治疗方案分别为卡培他滨(850 mg/m^ 2,第1~14天每天2次,每3周为1个周期)、替吉奥(40 mg/m^ 2,第1~14天每天2次,每3周为1个周期)口服,2组中奥沙利铂(130 mg/m ^2)在每周期第1天静脉滴注,曲妥珠单抗在第1周期第1天以8 mg/kg首剂,随后6 mg/kg静脉滴注。比较2组患者的疗效和不良反应发生情况。结果曲妥珠单抗-XELOX组患者的客观缓解率(RR)、疾病控制率(DCR)和中位无进展生存期(PFS)分别为38.1%、85.7%和7.6个月,曲妥珠单抗-SOX组患者的RR、DCR和中位PFS分别为47.4%、84.2%和8.2个月,2组近期、远期疗效比较,差异无统计学意义(P>0.05)。曲妥珠单抗-XELOX组3~4度手足综合征的发生率显著高于曲妥珠单抗-SOX组(P<0.05),其他不良反应发生率比较,差异无统计学意义(P>0.05)。结论曲妥珠单抗联合SOX方案与曲妥珠单抗联合XELOX方案的疗效相当,但安全性更好,可与曲妥珠单抗联合XELOX方案互换用于Her-2阳性晚期胃癌的一线治疗。

Objective To evaluate treatment outcomes between tratuzumab in combination with capecitabine as well as oxaliplatin(XELOX)and tratuzumab in combination with gimeracil as well as oxaliplatin(SOX)therapies in patients with human epidermal growth factor receptor-2(Her-2)positive advanced gastric cancer.Methods Patients(n=40)who received trastuzumab-XELOX or trastuzumab-SOX therapy as first-line chemotherapy were separately assigned to the trastuzumab-XELOX group(n=21)or trastuzumab-SOX group(n=19),capecitabine(850 mg/m^ 2,twice a day,lasting for 1 to 14 d,every 3 weeks was a chemotherapy cycle)or gimeracil(40 mg/m ^2,twice a day,lasting 1 to 14 d,every 3 weeks was a chemotherapy cycle)were separately administered.On 1 st day of each cycle,130 mg/m ^2 of oxaliplatin was intravenously infused in each chemotherapy cycle in both groups.Taking 8 mg/kg on first day of each cycle as fist dosage and 6 mg/kg afterwards,trastuzumab was also intravenously infused.The efficacy and adverse reactions of the two groups were compared.Results In the trastuzumab-XELOX group,response rate(RR),disease control rate(DCR)and progression-free survival(PFS)period were 38.1%,85.7%and 7.6 months,respectively.In the trastuzumab-SOX group,RR,DCR and PFS were 47.4%,84.2%and 8.2 months,respectively.There were no significant differences in short-and long-term efficacy between two groups(P>0.05).Grade 3 or 4 hand-foot syndrome was more frequently observed in the trastuzumab-XELOX group than in the trastuzumab-SOX group,there was no significant difference in the incidence of other adverse reactions(P>0.05).Conclusion Trastumuzab-SOX therapy has the equal efficacy versus trastumuzab-XELOX therapy,but the former has better safety,and can be used interchangeably for patients with Her2-positive advanced gastric cancer.