奥沙利铂联合卡培他滨或替吉奥治疗进展期胃癌的临床观察

Clinical Efficacy of Oxaliplatin Combined with Capecitabine(XELOX) and Oxaliplatin Combined with S-1(SOX) on Advanced Gastric Cancer

目的观察奥沙利铂联合卡培他滨(XELOX)与奥沙利铂联合替吉奥(SOX)治疗进展期胃癌的有效性和安全性。方法 52例进展期胃癌患者分入XELOX组和SOX组,其中XELOX组25例,奥沙利铂(Oxaliplatin,OXA)130 mg/m2,第1天,卡培他滨(Capecitabine,Xeloda)1 000 mg/m2,口服,每天两次,第1~14天,每21天为一周期;SOX组27例,奥沙利铂130 mg/m2,第1天,S-1 40 mg/m2,口服,每天两次,第1~14天,每21天为一周期。根据不良反应的程度调整药物用量。每两周期评价疗效。结果52例患者均可评价疗效,XELOX组CR 0例(0),PR 13例(52.0%),SD 7例(28.0%),PD 5例(20.0%),RR 52.0%,PFS 6.9月,OS 12.1月;SOX组CR 1例(3.7%),PR 12例(44.4%),SD 8例(29.6%),PD 6例(22.2%),RR 48.1%,PFS 7.2月,OS 11.2月。两组间RR、PFS、OS差异无统计学意义(P>0.05);两组间临床分期Ⅲ期者疗效明显优于Ⅳ期者(P<0.01);常见的不良反应主要为骨髓抑制、胃肠道反应、乏力、口腔黏膜炎、手足综合征、神经毒性。XELOX组的手足综合征发生率明显高于SOX组,差异有统计学意义(P<0.01)。结论 XELOX方案和SOX方案治疗进展期胃癌疗效相当,不良反应轻,患者可耐受。

Objective To observe the clinical efficacy and security of oxaliplatin combined with capecitabine(XELOX) and oxaliplatin combined with S-1(SOX) for advanced gastric cancer(AGC)patients. Methods Fifty-two AGC patients were divided into XELOX group(25 cases) and SOX group(27 cases). For XELOX group, capecitabine 1 000 mg/m2, orally bid, days 1-14 and oxaliplatin 130 mg/m2, intravenously, day 1, 21 days was a cycle. For SOX group, S-1 40 mg/m2, orally bid, days 1-14 and oxaliplatin 130 mg/m2, intravenously, day 1, 21 days was a cycle. The dose was adjusted according to adverse effects. The efficacy was evaluated every 2 cycles. Results All patients were evaluated for efficacy and toxicity. In XELOX group, 0 patients with complete response(CR), 13 patients(52.0%) with partial response(PR), 7 patients(28.0%) with stable disease(SD), 5 patients(20.0%) with progressive disease(PD), total 13 patients(52.0%) with complete and partial response(RR). The median progression free survival was 6.9 months and the median overall survival was 12.1 months. In SOX group, 1 patient(3.7%) with CR, 12 patients(44.4%) with PR, 8 patients(29.6%) with SD, 6 patients(22.2%) with PD, total 13 patients(48.1%) with RR. The median progression free survival was 7.2 months and the median overall survival was 11.2 months. There was no significant difference of RR, PFS and OS between both groups(P>0.05). In both groups, the clinical efficacy in stage Ⅲwas significantly better than that in stage Ⅳ(P<0.01). The common toxicities included myelosuppression, anorexia, nausea, asthenia, oralmucositis, hand-foot syndrome and neurotoxicity. The incidence rate of hand-foot syndrome in XELOX group was higher than that in SOX group(P <0.01). Conclusion Both XELOX and SOX are effective for AGC patients, with tolerated toxicities.