替吉奥联合奥沙利铂在进展期胃癌患者中的应用价值

The Application Value of S-1 Combined with Oxaliplatin for Advanced Gastric Cancer

目的:探讨替吉奥胶囊联合注射用奥沙利铂(SOX方案)在进展期胃癌中应用的有效性和安全性。方法选取76例进展期胃癌患者为研究对象,随机分为观察组和对照组各38例。观察组采用口服替吉奥胶囊80 mg/(m2·d)2次/d,第1~14天;奥沙利铂130 mg/(m2·d),第1天,静脉滴注,3周为1个疗程。对照组采用奥沙利铂130 mg/(m2·d),第1天,静脉滴注;口服卡倍他滨2 000 mg/(m2·d),2次/d,第1~14天,3周为1个疗程。治疗2个疗程后比较2组患者的临床疗效、生活质量及不良反应情况。结果观察组患者治疗后的总有效率和临床获益率分别为68.4%和92.1%,对照组分别为55.3%和76.3%,2组比较,差异有统计学意义(P<0.05);观察组患者治疗后生存质量(KPS评分)优于对照组,差异具有统计学意义(P<0.05);2组患者的不良反应主要为血液学毒性、胃肠道反应等,以Ⅰ~Ⅱ度为主,观察组患者白细胞计数下降率、恶心呕吐发生率、腹泻发生率分别为39.5%、42.1%、10.5%,显著低于对照组的65.8%、89.5%、36.8%,均具有统计学意义(P<0.05),其他不良反应则无统计学意义(P>0.05)。结论替吉奥联合奥沙利铂治疗进展期胃癌具有较高的有效性,不良反应率较低,可明显改善患者的生存质量,值得在临床推广应用。

Objective To explore the efficacy and safety of S-1 combined with oxaliplatin injection( SOX scheme) for advanced gastric cancer. Methods 76 cases of advanced gastric cancer patients were randomly divided into the observation group and the control group,with 38 cases in each group. The observation group received S-1 80 mg /( m2·d) twice a day orally,from 1to 14 days,and oxaliplatin 130 mg /( m2·d) with intravenous drip on the first day,3 weeks was 1 cycle. The control group received oxaliplatin 130 mg /( m2·d) with intravenous drip on the first day and Capecitabine 2 000 mg/( m2·d) twice a day,from1 to 14 days,3 weeks was 1 cycle. The clinical curative effect,life quality and adverse reactions of the 2 groups after 2 courses of treatment were compared. Results The total effective rate and clinical benefit rate after treatment in the observation group were68. 4% and 92. 1% respectively,while those of the control group were 55. 3% and 76. 3% respectively,there was a statistical difference( P < 0. 05); The quality of life( KPS score) after treatment in the observation group was better than that of the control group,there was a statistical difference( P < 0. 05); The adverse reactions of the 2 groups were mainly Ⅰ ~ Ⅱ degree hematologic toxicity,gastrointestinal reaction,etc,the leukocyte count decline rate,incidence of nausea and vomiting,diarrhea incidence of the observation group were 39. 5%,42. 1%,10. 5% respectively,which were significantly lower than those of the control group( 65.8%,89.5%,36.8%),there was a statistical difference( P <0.05),while there was no statistical difference( P >0.05) in other adverse reactions. Conclusion S-1 combined with oxaliplatin for advanced gastric cancer has high efficiency,lower adverse reaction rate,it can obviously improve the patient's quality of life,and it is worthy of clinical application.