奥沙利铂联合替加氟和亚叶酸钙治疗晚期胃癌的随机对照研究  

Randomized controlled study of oxaliplatin combined with tegafur and calcium foUnate in treatment of advanced gastric cancer

作　　者：刘艳[1] 刘佳丽[1] 许崇安[1] 李琳[1] 冯丹[1] 邢丽丽[1] 

机构地区：[1]中国医科大学附属第四医院肿瘤内科,沈阳110032

出　　处：《肿瘤研究与临床》2011年第9期620-622,625,共4页Cancer Research and Clinic

摘　　要：目的比较奥沙利铂（L—OHP）联合替加氟（FT207）和亚叶酸钙（CF）方案和FOLFOX4方案治疗晚期胃癌的临床疗效和不良反应。方法120例晚期胃癌患者根据随机数字表法分为两组，观察组60例采用L-OHP联合FT207和CF改良方案治疗，对照组60例采用L-OHP联合CF和5-氟尿嘧啶（5-Fu）的FOLFOX4方案治疗。治疗2—6个周期后评价疗效。结果观察组临床有效38例（63．3％），对照组25例（41．7％），两组差异有统计学意义（χ2=5．647，P=0．028）。观察组患者的中位无进展生存期（TTP）7．7个月，中位总体生存期（OS）11．6个月，对照组患者的中位TTP7．3个月，中位OS10．1个月，两组差异均有统计学意义（P=0．032，P=0．005）。观察组患者Kamofsky评分改善率明显优于对照组，差异有统计学意义（χ2=6．806，P=0．015）。观察组骨髓抑制发生率低于对照组（χ2=4．821，P=0．044），两组问其他不良反应发生率未见明显差异。结论L—OHP联合FT207和CF方案治疗晚期胃癌的临床疗效及安全性优于FOLFOX4方案，值得临床推广应用。Objective To compare the efficacy and safety of oxaliplatin combined with tegafur and calcium folinate with FOLFOX4 regimens on patients with advanced gastric cancer. Methods 120 patients with advanced gastric cancer were randomly divided into two groups, concluding 60 cases in observation group （modified group） treated with oxaliplatin combined with tegafur and leueovorin and 60 cases in control group （FOLFOX4 group） treated with oxaliplatin combined with calcium folinate and fluorouracil. Clinical efficacy was evaluated after 2 （3-6） cycles. Results The clinical efficacy rates of observation group and control group were 63.3 % （38/60） and 41.7 % （25/60）, respectively （χ2 =5.647, P =0.028）. The median progression-free survival and median overall survival of patients in observation group were 7.7 months and 11.6 months, respectively, and those in control group were 7.3 months and 10.1 months, respectively. The median progression-free survival （P =0.032） and median overall survival （P =0.005） were statistically significant differences. The increased ratio of Karnofsky score of patients in observation group was higher than that in control group （P =0.015）. The incidence of myelosuppression in observation group was lower than that in control group （P =0.044）. There was no significant difference between the two groups on other adverse reaction rates. Conclusion The efficacy and safety of oxaliplatin plus tegafur and leucovorin in the treatment of advanced gastric cancer is superior to FOLFOX4 regimen, and worthy of clinical application.

关 键 词：胃肿瘤 治疗结果 奥沙利铂 替加氟 亚叶酸钙 

分 类 号：R735.2[医药卫生—肿瘤]