腹腔灌注顺铂联合紫杉醇、替吉奥多途径给药治疗胃癌腹膜转移的临床观察

Clinical observation of peritoneal infusion ofcisplatin combined with paclitaxel and TS-1 in the treatment of peritoneal metastasis of gastric cancer

目的效。方法收集了2012年3月至2018年10月在岳阳中西医结合医院肿瘤科采用顺铂(40 mg/m^2腹腔灌注)、紫杉醇(50 mg/m^2静滴)、TS-1(50 mg/m^2口服)联合化疗方案治疗的胃癌腹膜转移患者的临床资料,评价患者的疗效和毒副反应,KaplanMeier法绘制生存曲线。结果 77例患者至少完成2个周期化疗,均可评价疗效,客观缓解率为54.5%(42/77)。77例患者1年生存率为52%,2年生存率为25%,3年生存率为5%,中位OS为12.0个月(95%CI:8.2~15.8个月)。27例伴肝转移患者的中位OS为8.0个月(95%CI:4.9~11.1个月)。伴腹水患者中位OS为9个月(95%CI:4.1~13.9个月),无腹水患者中位OS达14个月(95%CI:10.5~17.5个月),差异有统计学意义(P=0.05)。常见不良反应主要为1~2级的胃肠道毒性、血液学毒性及脱发。结论顺铂(腹腔灌注)、紫杉醇(静脉注射)和TS-1(口服)三药联合多途径给药方案治疗腹膜转移性胃癌有效且安全性较好。

Objective To investigate the efficacy of multiple chemotherapy regimens of intraperitoneal infusion of cisplatin combined with paclitaxel(intravenous)and TS-1(oral)in patients with advanced peritoneal metastatic gastric cancer.Methods Clinical data of patients with peritoneal metastasis of gastric cancer treated with cisplatin(40mg/m 2 intraperitoneal infusion),paclitaxel(50 mg/m 2 intravenous infusion)and TS-1(50 mg/m 2 oral)combined with chemotherapy in in the Oncology Department of Yueyang Integrated Traditional Chinese and Western Medicine Hospital from March 2012 to October 2018 were collected.The efficacy and toxic side effects of the patients were evaluated.The survival curve was plotted by kaplan-meier method.Results The efficacy could be evaluated in 77 patients who had completed at least two cycles of chemotherapy,and the objective remission rate was 54.5%(42/77).The 1-year,2-year and 3-year survival rate were 52%,25%and 5%in 77 patients,with a median OS of 12.0 months(95%CI:8.2-15.8 months).The median OS of 27 patients with liver metastasis was 8.0 months(95%CI:4.9-11.1 months).The median OS of the patients with ascites was 9 months(95%CI:4.1-13.9 months),and the median OS of the patients without ascites was 14 months(95%CI:10.5-17.5 months).The difference was statistically significant(P=0.05).The most common adverse reactions were grade 1 to 2 gastrointestinal toxicity,hematologic toxicity and alopecia.Conclusion The combination of cisplatin(intraperitoneal perfusion),paclitaxel(intravenous infusion)and TS-1(oral administration)is effective and safe in the treatment of peritoneal metastatic gastric cancer.