沙利度胺联合DOF方案与单纯DOF方案一线治疗晚期胃癌的疗效观察

Curative Effect of DOF Combined with Thalidomide Regimen and DOF Regimen Alone as First-line Treatment for Advanced Gastric Cancer

目的观察DOF联合沙利度胺对比单纯DOF方案一线治疗晚期胃癌的疗效及不良反应。方法将114例晚期胃癌患者随机分为DOF方案联合沙利度胺组(联合组)和DOF方案组(化疗组),每组均为57例,2周为1个化疗周期。对两组的近期有效率(RR率)、中位疾病进展时间(m TTP)、中位生存时间(MST)、不良反应进行比较分析。结果联合组和化疗组的有效率分别为61.4%和49.1%(P<0.05);中位疾病进展时间分别为6.9月和6.0月(P<0.05);中位生存时间分别为10.9月和10.5月(P>0.05);不良反应:联合组恶心呕吐、腹泻发生率低于化疗组(P<0.05),睡眠改善,但联合组便秘发生率高于化疗组(P<0.05),其余不良反应比较,差异无统计学意义。结论与单用DOF方案化疗相比,DOF方案联合沙利度胺治疗晚期胃癌有较好的近期有效率及中位疾病进展时间,同时改善患者生活质量,不良反应易于耐受。

Objective To observe the curative effect and adverse reactions of DOF regimen combined with thalidomide and DOF regimen alone as the first-line treatment for advanced gastric cancer. Methods A total of 114 patients with advanced gastric cancer were randomly divided into DOF combined with thalidomide group(Combination group) and DOF alone group(Chemotherapy group), 57 cases each, two weeks as a cycle. Recent response rate(RR), median time to progression(m TTP), median survival time(MST) and side effects were analyzed after 4 cycles. Results RR of Combination group and Chemotherapy group were 61.4% and 49.1%(P<0.05); m TTP were 6.9 and 6.0 months(P<0.05); MST were 10.9 and 10.5 months(P> 0.05); the incidence of nausea and vomiting in Combination group were lower than those in Chemotherapy group(P<0.05), but the peripheral neurotoxicity and constipation in Combination group were higher than those in Chemotherapy group(P<0.05); no statistical difference was observed in other side effects. ConclusionCompared with DOF alone, DOF combined with thalidomide in advanced gastric cancer patients has better RR, m TTP and QOL; at the meantime, the side effects are easier to be tolerated.