替吉奥联合腹腔内化疗治疗胃癌合并腹水的临床疗效观察  

Efficacy and safety of S-1 combined with intraperitoneal chemotherapy in advanced gastric carcinoma patients with ascites

作　　者：毛丽伟[1] 廖国清[1] 王红梅[1] 解国清[1] 李仁德[1] 

机构地区：[1]解放军309医院肿瘤科,北京100091

出　　处：《现代肿瘤医学》2012年第6期1238-1240,共3页Journal of Modern Oncology

摘　　要：目的:探讨替吉奥(S-1)联合腹腔内化疗治疗伴有恶性腹水的胃癌的疗效和安全性。方法:43例晚期胃癌合并腹水患者,根据体表面积确定替吉奥初始剂量,体表面积<1.25m2,替吉奥40mg/次,2次/d;体表面积1.25-1.5m2,替吉奥50mg/次,2次/d;体表面积>1.5m2,替吉奥60mg/次,2次/d,早、晚饭后分别口服1次,连续服用14d,停药7d,21d为1周期。顺铂加入0.9%生理盐水100ml腹腔内灌注,d190mg,d860mg,21d为1周期,2周期后行疗效评价。按照WHO标准评价客观疗效和不良反应。结果:43例患者均可进行客观疗效及安全性评价,CR 3例,PR 18例,NC+PD 22例,腹水有效控制率(CR+PR)为48.8%(21/43)。临床受益反应为72.1%(31/43)。不良反应主要是血液学毒性、胃肠道反应。Ⅲ-Ⅳ度的白细胞减少占14.0%(6/43)。结论:替吉奥胶囊联合DDP方案治疗胃癌合并腹水近期疗效较好,不良反应可以耐受,值得进一步研究应用。Objective：To evaluate the efficacy and safety of S-1 combined with intraperitoneal chemotherapy in advanced gastric carcinoma with ascites.Methods：Forty-three patients with advanced gastric carcinoma with medium and abundant ascites were selected.In patients assigned to S-1 plus cisplatin,S-1（40-60mg depending on patient＇s body area） was given orally,twice daily for 14 days.The medication lasted for fourteen days,followed by 7 days rest.At the same time,90mg cisplatin plus 100ml 0.9% physiological saline were given in peritoneal cavity on the first day and 60mg cisplatin on eight day respectively,twenty one days as a cycle,2 cycles totally.The efficacy and adverse effects were evaluated according to the common toxicity criteria of WHO.Results：All 43 patients could be given an objective evaluation of the efficacy and safety,3 cases of CR,18 cases of PR,22 cases of（NC＋PD）,the objective response rate（CR＋PR） was 48.8%（21/43）.The main side effects were gastrointestinal reactions haematology toxicity,the decrease of grade Ⅲ-Ⅳ leukocytes accounted for 11.6%（6/43）.Conclusion：S-1 capsule combined with DDP is safe and effective in the treatment of advanced gastric carcinoma with ascites.The adverse effects are tolerant.It is worthy of studying further in clinic.

关 键 词：替吉奥 顺铂 胃癌 腹水 

分 类 号：R735.2[医药卫生—肿瘤] R979.1[医药卫生—临床医学]