环氧合酶-2抑制剂联合XELOX方案一线治疗晚期胃癌24例  

Cyclooxygenase-2 inhibitor combined with capecitabine and oxaliplatin (XELOX) as a first-line therapy for advanced gastric cancer: An analysis of 24 cases

作　　者：潘战和[1] 苏安[1] 王馨[1] 吕霞[1] 蔡清清[2] 高岩[2] 

机构地区：[1]厦门大学附属中山医院肿瘤科,福建省厦门市361004 [2]中山大学附属肿瘤医院化疗科,广东省广州市510060

出　　处：《世界华人消化杂志》2013年第3期261-265,共5页World Chinese Journal of Digestology

摘　　要：目的:评价环氧合酶-2(cyclooxygenase-2,COX-2)抑制剂塞来昔布联合XELOX方案治疗晚期胃癌的疗效及不良反应.方法:将47例符合入组条件的晚期胃癌患者随机分为两组,试验组24例,采用XELOX方案联合塞来昔布治疗;对照组23例,采用XELOX方案治疗,不加塞来昔布.每21d为一周期,每2周期评价疗效.结果:试验组和对照组的总有效率(response rate,RR)分别为50.0%(12/24)和39.1%(9/23),两组比较差异无统计学意义(P>0.05);疾病控制率(disease control rate,DCR)分别为91.7%(22/24)和65.2%(15/23),两组比较差异有统计学意义(P<0.05).生活质量改善率分别为83.3%和56.5%,差异有统计学意义(P<0.05).中位疾病进展时间(median time to progression of disease,mTTP)分别为7.2mo、5.7mo,差异有统计学意义(P<0.05);中位生存期(median survival time,MST)分别为12.5mo、11.3mo,1年总生存率(Overall survival,OS)分别为47.6%、41.2%,试验组好于对照组,但差异无统计学意义(P>0.05).试验组手足综合征发生率(12.5%)较对照组(39.1%)低,差异有统计学意义(P<0.05),其他不良反应两组相似,且均无化疗相关性死亡.结论:环氧合酶-2抑制剂联合XELOX方案治疗晚期胃癌能提高疾病控制率,改善患者生活质量,并能降低手足综合征发生率,同时能延长疾病进展时间,但未能延长总生存,值得临床进一步研究.AIM： To evaluate the efficacy and toxicity of oxaliplatin combined with capecitabine （XELOX regimen） plus cyclooxygenase-2 （COX-2） inhibitor celecoxib in the treatment of advanced gastric cancer （AGC）. METHODS： Forty-seven eligible patients were randomly assigned to a trial group and a control group. In the trial group, 24 patients were treated with celecoxib plus the XELOX regimen, while 23 patients in the control group omitted the oral intake of celecoxib. Treatment was repeated every 3 wk. RESULTS： There was no significant difference in the overall response rate （RR） between the trial group and control group （50.0% vs 39.1%, P〈0.05）. The disease control rate （DCR） was significantly higher in the trial group than in the control group （91.7% vs 65.2%, P〈0.05）. The percentage of patients with improved quality of life （QOL） was significantly higher in the trial group than in the control group （83.3% vs 56. 5%, P〈0.05）. The median time to progression （mTTP） was significantly longer in the trial group than in the control group （7.2 mo vs 5.7 mo, P〈0.05）. The median survival time （MST） and one-year overall survival （OS） rate in the trial group were higher than these in the control group, but there was no statistically significant difference between the two groups （MST： 12.5 mo vs 11.3 mo; OS rate： 47.6% vs 41.2%; both P〈0.05）. The incidence of hand-foot syndrome （HFS） was significantly lower in the trial group than in the control group （12.5% vs 39.1%, P〈0.05）. Other toxicities were similar between the two groups. No chemotherapy-related death occurred. CONCLUSION： COX-2 inhibitor combined with the XELOX regimen can improve the disease control rate and quality of life, reduce the incidence of hand-foot syndrome, and benefit median time to progression, but not overall survival time, in the treatment of advanced gastric cancer.

关 键 词：晚期胃癌 塞来昔布 奥沙利铂 卡培他滨 疗效 

分 类 号：R735.2[医药卫生—肿瘤]