替吉奥联合奥沙利铂与单药替吉奥治疗老年胃癌的疗效分析

Efficacy of S-1 with oxaliplatin(SOX)and monotherapy S-1 in the treatment of elderly gastric cancer

目的 采用回顾性分析方法对奥沙利铂联合替吉奥(SOX)或替吉奥单药(S-1)治疗老年胃癌的临床疗效及安全性进行评估,为老年胃癌患者的临床治疗提供依据。方法 回顾性研究2017年1月~2020年10月在院接受SOX或单药S-1作为一线治疗的76例老年胃癌患者,按化疗方案分组,分析并比较两组患者的有效性及安全性。结果 SOX组纳入老年胃癌患者41例,总有效率(ORR)为53.7%;S-1组纳入老年患者35例,总有效率(ORR)为28.6%,差异有统计学意义(P=0.027);SOX、S-1组中位OS分别为15.4个月和9.3个月,差异有统计学意义(P=0.008),中位无进展生存期(PFS)分别为6.7个月和4.3个月,差异有统计学意义(P=0.014)。SOX和S-1组化疗前后肿瘤标志物CEA、CA199、CA125的变化差异有统计学意义(P<0.05)。两组发生的不良反应如骨髓抑制(白细胞减少、中性粒细胞减少、血小板减少)、胃肠道反应(恶心、呕吐、腹泻)、外周神经病变、疲劳乏力等的发生率差异无统计学意义(P>0.05)。结论 SOX联合化疗方案较S-1单药治疗老年胃癌的临床疗效更佳,同时两组化疗方案所导致的不良反应差异无统计学意义,推荐SOX联合化疗作为老年胃癌患者临床治疗的首选方案。

Objective To evaluate the clinical efficacy and safety of oxaliplatin combined with S-1(SOX)or S-1 monotherapy for elderly gastric cancer through retrospective studies,in order to more effectively guide the clinical use of elderly patients with gastric cancer.Methods From January 2017 to October 2020,a retrospective study was conducted on 76 elderly patients with gastric cancer who received SOX or S-1 monotherapy as the first-line treatment in our hospital,grouped by chemotherapy regimen,and the clinical efficacy of the two groups of patients and the incidence of adverse reactions caused by treatment were analyzed and compared.Results The SOX group included 41 elderly patient cases with an overall effective rate(ORR)of 53.7%,while the S-1 group included 35 elderly patient cases,with an overall effective rate(ORR)of 28.6%,,and the difference was statistically significant(P=0.027).The median OS in the SOX and S-1 groups were 15.4 months and 9.3months,the difference was statistically significant(P=0.008),the median morphosis-free survival(PFS)in the SOX and S-1 groups were 6.7months and 4.3months,the difference was statistically significant(P=0.014).The levels of tumor markers CEA,CA199 and CA125 after chemotherapy in the SOX and S-1 groups were compared,the difference was statistically significant(P<0.05).The incidence of adverse reactions such as bone marrow suppression(leukopenia,neutropenia,platelet decline),gastrointestinal reactions(nausea,vomiting,diarrhea),peripheral neuropathy,fatigue and fatigue caused by the two groups of chemotherapy regimens was compared,and the difference was not statistically significant(P>0.05).Conclusion The SOX combination chemotherapy regimen has better clinical efficacy than S-1 monotherapy for elderly gastric cancer,and the incidence of adverse reactions caused by the two sets of chemotherapy regimens is not statistically significant,and SOX combined chemotherapy is recommended as the preferred regimen for clinical treatment of elderly patients with gastric cancer.