雷替曲塞联合奥沙利铂二线治疗晚期胃癌的疗效及安全性

Efficacy and safety of raltitrexed combined with oxaliplatin in the second-line chemotherapy of advanced gastric cancer

目的:观察雷替曲塞联合奥沙利铂二线治疗晚期胃癌的疗效及安全性。方法:选取2010年1月至2015年10月化疗失败后的30例晚期胃癌患者,随机分成2组(各15例),一组予雷替曲塞联合奥沙利铂治疗(观察组),即雷替曲塞3 mg/m^2,d_1;奥沙利铂85 mg/m^2,d_1。另一组予卡培他滨联合奥沙利铂治疗(对照组),即卡培他滨1 000 mg/m^2,bid po,d1~14,奥沙利铂130 mg/m^2,d_1。以上两组方案21 d为1个周期,每2个周期评价疗效。结果:观察组vs对照组疾病控制率(DCR)73.33%vs 66.67%(P=0.69),总有效率(RR)20%vs 13.33%(P=0.62),中位无进展生存时间(mPFS)3.91个月vs 3.72个月(P=0.32),中位生存时间(mOS)8.07个月vs 6.48个月(P=0.64)。恶心、呕吐发生率、白细胞减少、血小板减少、周围神经毒性、口腔黏膜炎、腹泻、转氨酶升高及心脏毒性,两组比较无差异。结论:对于晚期胃癌的二线化疗,雷替曲塞联合奥沙利铂疗效不劣于其他方案,且毒副反应可耐受,可作为晚期胃癌的一种治疗选择。

Objective: To explore the efficacy and safety of raltitrexed combined with oxaliplatin in the second-line chemotherapy for advanced gastric cancer. Methods: The data of 30 patients were retrospectively collected derived from patients with pathologically proved advanced gastric cancer who have received second-line chemotherapy in Baoying People’s Hospital during the period from January 2010 to October 2015. The treated with raltitrexed combined with oxaliplatin chemotherapy patients as the observation group( 15 cases),accept capitabine combined with oxaliplatin chemotherapy patients as control group( 15 cases),analysis the curative effect and adverse reaction between the two groups. Results: In observation group,CR 0 case,PR 3 cases,SD 8 cases,PD 4 cases,DCR was 73. 33%,ORR was 20%. In control group CR 0 case,PR 2 cases,SD 8 cases,PD 5 cases,DCR was 66. 67%. ORR was 13. 33%. The median PFS was 3. 91 months and 3. 72 months,OS was 8. 07 months and 6. 48 months in observation group and control group. Two groups of the main adverse reactions of the white blood cells and neutropenia,nausea,vomiting,transaminase lifts had no statistical differences. Conclusion: For the second-line chemotherapy of advanced gastric cancer patients,raltitrexed combined with oxaliplatin treatmet can achieve efficacy,side effects can be tolerated,which has a broad prospect in clinical treatment.