替吉奥联合奥沙利铂对比替吉奥联合顺铂方案一线治疗老年晚期胃癌的临床研究  

Clinical study of S-1 plus oxaliplatin versus S-1 plus cisplatin as the first-line treatment for 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,南京210024

出　　处：《临床肿瘤学杂志》2013年第1期50-53,共4页Chinese Clinical Oncology

摘　　要：目的探讨替吉奥联合奥沙利铂方案(SOX)与替吉奥联合顺铂方案(SP)一线治疗老年晚期胃癌的疗效和毒副反应。方法将56例老年晚期胃癌患者随机分为SOX组(n=30)和SP组(n=26)。SOX组:奥沙利铂130mg/m2静滴,d1;替吉奥40～60mg/次口服,每天2次,d1～d14,21天为1周期。SP组:顺铂25mg/m2静滴,d1～d3;替吉奥用法同SOX组,21天为1周期。至少2个周期进行疗效评价。结果 SOX组和SP组的有效率分别为46.7%和38.5%(P=0.596),疾病控制率分别为80.0%和76.9%(P=1.000);中位无进展生存时间分别为6.0个月和5.6个月(P=0.831),中位总生存时间分别为12.3个月和11.5个月(P=0.401)。SOX组和SP组的毒副反应均以血液学毒性为主,3～4级发生率的差异无统计学意义;非血液学毒性两组均为1～2级,SOX组以周围神经炎为主,SP组主要为恶心呕吐和肾功能异常。SOX组和SP组的KPS评分提高率分别为83.3%和46.2%(P=0.027),FACT-G评分提高率分别为76.7%和38.5%(P=0.006)。结论老年晚期胃癌患者可从替吉奥联合奥沙利铂方案或替吉奥联合顺铂方案一线治疗中获益,但替吉奥联合奥沙利铂方案的毒副反应更小,安全性更好。Objective To investigate the efficacy and toxicity of S-1 plus oxaliplatin versus S-I plus cisplatin as the first-line treatment for elderly patients with advanced gastric cancer. Methods Fifty-six elderly patients with advanced gastric cancer were randomly divided into S-1 plus oxaliplatin group（ SOX, n = 30） and S-1 plus eisplatin group（ SP, n = 26）. In SOX group, S-1 was ad- ministered orally（40-60mg, bid） from d1 to d14, and oxalipatin（ 130mg/m^2） was administered intravenously on d1. Every 21 days was a cycle. In SP group, cisplatin was administeredintravenously 25 mg/m^2 on d1-d3 , and the administration of S-1 followed the same dosage as SOX group. Every 21 days was a cycle. Efficacy was evaluated every two cycles. Results The effective rates of SOX group and SP group were 46.7% and 38.5 % （P = 0. 596）, the disease control rates were 80. 0% and 76. 9% （P = 1. 000）, the median progressfree survival were 6.0 months and 5.6 months（P = 0. 831 ）, and the median overall survival were 12. 3months and 11.5 months （P =0. 401 ）. The main toxicity in the two groups was hematological toxicity, and the occurrence of grade 3-4 toxicity in SOX group and SP group had no difference. The non-hematological toxicity in the two groups was all in grade 1-2, and the main toxicity was peripheral neuritis in SOX group, while in SP group were abnormal renal function and nausea/vomitting. The improvement rate of KPS score in SOX group and SP group were 83.3% and 46.2% （P =0. 027） , and the increased rate of FACT-G score were 76.7% and 38.5% （P=0. 006）. Conclusion Both SOX and SP regimen are effective for elderly patients with advanced gastric cancer. Compared with SP regimen, SOX regimen is better tolerated as the first-line treatment for advanced gastric cancer.

关 键 词：替吉奥 奥沙利铂 顺铂 晚期胃癌 老年 化学治疗 

分 类 号：R735.2[医药卫生—肿瘤]