替吉奥联合奥沙利铂一线治疗老年晚期胃癌的疗效分析  

Effects of oteracil combined with oxaliplatin as first-line treatment in elderly patients with advanced gastric cancer

作　　者：樊卫飞[1] 王峻[1] 孟丽娟[1] 刘福银[1] 蒲骁麟[1] 杨民[1] 

机构地区：[1]江苏省老年医学研究所肿瘤内科,江苏省南京市210024

出　　处：《实用老年医学》2013年第3期240-243,共4页Practical Geriatrics

摘　　要：目的 比较一线替吉奥联合或不联合奥沙利铂方案治疗老年晚期胃癌患者的疗效和不良反应。方法 回顾性分析61例一线替吉奥联合或不联合奥沙利铂方案治疗经病理确诊的老年晚期胃癌患者的临床数据。替吉奥联合奥沙利铂组(治疗组)31例,替吉奥组(对照组)30例。治疗组用法:替吉奥:体表面积<1.25m2,每次40mg,每日2次;体表面积≥1.25m2,每次50mg,每日2次,持续14d,休息7d;奥沙利铂:130mg/m2,第1天给药,每3周重复;对照组用法:替吉奥用法同治疗组。化疗持续至疾病进展或出现无法耐受的不良反应。结果 治疗组客观有效率(RR)为48.3%,肿瘤控制率(TGCR)为74.2%,中位无疾病进展时间(PFS)为6.1月,中位总生存时间(OS)为11.6月;对照组RR为23.3%,TGCR为50.0%,PFS为4.3月,OS为7.9月。治疗组疗效更佳。2组生存质量评分均改善,治疗组改善更佳。2组不良反应均可耐受,治疗组最常见的3/4级不良反应为血小板减少及中性粒细胞减少,2组3/4级贫血发病率分别为9.7%及10.0%。2组均无中性粒细胞减少性发热。2组均未见3/4级非血液学不良反应。没有治疗相关的死亡。结论 老年晚期胃癌患者可从替吉奥联合或不联合奥沙利铂方案化疗中获益,替吉奥联合奥沙利铂疗效更佳,2组不良反应均可耐受。Objective To compare the activity and safety of oteracil vs oteracil combined with oxaliplatin as first line therapy to treat advanced gastric cancer(AGC)in the elderly patients.Methods Clinical data from 61 patients with previously untreated AGC,who were histologically confirmed diagnosis of gastric adenocarcinoma and treated with oteracil/oxaliplatin(therapy group) or oteracil(control group),were reviewed.Thirty-one patients received the treatment of oteracil/oxaliplatin and 30 patients receiving oteracil regimens,respectively.The patients received oteracil at 40 mg [body surface area(BSA) < 1.25 m2] or 50 mg(BSA> 1.5 m2) twice a day for 14 days,followed by a 7-day rest period,and oxaliplatin 130 mg/m2 was administered on the 1st day in the therapy group.In the control group,the usage of oteracil was same with therapy group.The chemotherapy cycle was 3 weeks in both group.Treatment was continued until disease progression or the development of unacceptable toxicity.Results The therapy group had a response rate(RR) of 48.3%,a tumor growth control rate(TGCR) of 74.2%,a median progression-free-time(PFS) of 6.1 months and a median overal survival(OS) of 11.6 months.The control group had a RR of 23.3%,a TGCR of 50.0%,a median PFS of 4.3 months and a median OS of 7.9 months.The therapy group had a higher activity.In two groups,quality of life was improved and the therapy group had a higher improvement.The treatment was well tolerated.The most frequent grade 3 or 4 toxicities were neutropenia(16.1%) and thrombocytopenia(12.9%) in therapy group.A similar incidence of grade 3 or 4 anemia in both groups was recorded.No neutropenic fever occurred.None of the patients in both groups experienced grade 3 or 4 nonhematological toxicities.No treatment-related death occurred during the study period.Conclusions Elderly patients with untreated AGC could benefit from oteracil/oxaliplatin or oteracil regimens.Qteracil/oxaliplatin protocol has a higher activity.The treatment can be well tolerated.

关 键 词：替吉奥 奥沙利铂 老年人 晚期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]