替吉奥或卡培他滨联合顺铂治疗晚期胃癌临床疗效研究  

Curative Effect Analysis of S-1 Combined with Cisplatin or Capecitabine Combined with Cisplatin in the Treatment of Advanced Gastric Cancer

作　　者：巴楠[1] 吴敏[2] 王丽娟[2] 张红巧[2] 

机构地区：[1]郑州大学基础医学院,河南省郑州市450001 [2]郑州大学第五附属医院肿瘤科

出　　处：《中国全科医学》2012年第6期672-673,676,共3页Chinese General Practice

摘　　要：目的比较替吉奥联合顺铂(SP)与卡培他滨联合顺铂(XP)一线治疗体力状况(ECOG)评分0～1分初治晚期胃腺癌的疗效和安全性。方法将37例ECOG评分0～1分初治晚期胃腺癌患者随机分为两组。SP组18例,给予替吉奥80 mg.m-2.d-1;XP组19例,给予卡培他滨2 000 mg.m-2.d-1;均早晚分2次口服,连服14 d,停药7 d。顺铂均为75 mg/m2,第1天静脉滴注。21 d为1个周期。结果 37例患者均可评价疗效,SP组完全缓解(CR)1例,部分缓解(PR)8例,稳定(SD)4例,进展(PD)5例;XP组CR 0例,PR 8例,SD 5例,PD 6例。两组患者疗效间差异无统计学意义(P>0.05)。SP组和XP组患者肿瘤进展时间分别为5.9个月和5.5个月[HR=0.92,95%CI(0.72,1.13),P=0.065],总生存期分别为12.4个月和11.9个月[HR=0.94,95%CI(0.78,1.09),P=0.061]。两组的不良反应主要为骨髓抑制、消化道反应和乏力,SP组Ⅲ～Ⅳ度血小板减少发生率显著低于XP组(5.6%与15.8%,χ2=4.08,P=0.049),Ⅲ～Ⅳ度手足综合征的发生率亦显著低于XP组(0与21.1%,χ2=4.25,P=0.046)。结论 SP与XP治疗ECOG评分0～1分初治晚期胃腺癌患者疗效相当,但SP患者耐受性更好,值得临床进一步研究使用。Objective To compare the safety and efficacy of S - 1 combined with cisplatin and capecitabine combined with cisplatin in the initial treatment for patients with advanced gastric cancer whose ECOG is 0- 1. Methods Thirty - seven pa- tients with advanced gastric cancer and with ECOG from 0 to 1 were randomly divided into two groups. Patients in SP group （ n = 18） received S - 1 80 mg~ m-2 ~ d-1 ; Patients in XP group （ n = 19） received capeeitabine 2 000 mg ~ m-2 ~ d-1 ; oral ad- ministration twice a day in both groups for 14 days; Both groups were given cisplatin 75 mg/m2, iygtt on day one. The course was twenty - one days in two groups. Results All patients were evaluable. SP group： CR 1, PR 8, SD 4, PD 5 ; XP group ： CR 0, PR 8, SD 5, PD 6. The efficacy of the two groups showed no statistically significant difference （ P 〉 0. 05 ）. TI＇P were 5.9 months and 5.5 months respectively for each group [ HR = 0. 92, 95% CI （ 0. 72, 1.13 ）, P = 0. 065 ], OS were 12.4 months and 11.9 months respectively for each group [ HR =0. 94, 95% CI （0. 78, 1.09）, P =0. 061 ] . The main untoward effects were myelosuppression, gastroenteric reaction and weakness. SP group showed a lower rate of untoward effects than XP group. SP group also showed a lower rate of Ill ~ IV thromboeytopenia （5.6% vs 15.8%, X2 =4. 08, P =0. 049） and hand - foot syndrome （0 vs 21.1%, X2 = 4. 25, P = 0. 046） than XP group. Conclusion The treatment of the two groups were evidently effective, with SP group having better tolerance. The regimen could be clinically recommended.

关 键 词：胃肿瘤 替吉奥 卡培他滨 顺铂 治疗结果 

分 类 号：R735.2[医药卫生—肿瘤]