伊立替康或奥沙利铂联合氟尿嘧啶类药物一线治疗晚期胃癌的疗效观察  

Comparison between the effects of oxaliplatin or irinotecan combined with fluoropyrimidine in the treatment of advanced gastric cancer

作　　者：卜丽佳[1] 张逸寅[1] 熊福星[1] 郝吉庆[1] 

机构地区：[1]安徽医科大学第一附属医院肿瘤内科,合肥230022

出　　处：《安徽医科大学学报》2013年第11期1372-1375,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的观察与比较伊立替康或奥沙利铂联合氟尿嘧啶类药物一线治疗晚期胃癌的疗效和安全性。方法71例初治晚期胃癌患者，分别使用伊立替康（37例）180mg／m^2 d1或奥沙利铂（34例）85mg／m^2 d1联合氟尿嘧啶类药物：5-氟尿嘧啶（5-Fu）400mg/m^2静推d1，2＋5-Fu 600mg／m^2持续静滴22hd1，2＋亚叶酸钙200mg／m^2 d1，2，14d为1周期或口服卡培他滨1．0g／m。1日2次，d1～14，21d为1疗程或口服替吉奥25mg／m^2 1日2次，d1-14，21d为1疗程。结果65例患者可评价疗效。伊立替康组和奥沙利铂组的有效率分别为32．35％和22．58％，疾病控制率分别为76．47％和70．97％，中位无进展生存时间分别为5个月（3．962-6．038个月）和4个月（2．730-5．270个月），两组问差异均无统计学意义（P〉0．05）。两组患者不良反应易耐受，主要为粒细胞减少和恶心、呕吐。伊立替康组腹泻发生率较高，为45．95％。奥沙利铂组外周神经损伤的发生率为29．41％。结论伊立替康或奥沙利铂联合氟尿嘧啶类药物一线治疗晚期胃癌的疗效相当，不良反应可以耐受。Objective To retrospectively observe and compare the efficacy and salty of irinotecan or oxaliplatin combined with fluoropyrimidine in the first line treatment of advanced gastric cancer. Methods 71 patients were divided into two groups. The irinoteean group consisted of 37 patients. Irinotecan 180 mg/m^2 was injected in 90 minutes on dl. And the oxaliplatin group consisted of 34 patients. Oxaliplatin 85 mg/m^2 was injected on dl. All the groups combined fluoropyrimidine. 5-Fluorouracil （5-Fu） 400 mg/m^2 and leucovorin 200 mg/m^2 were injected on dl ,2 and 5-Fu 600 mg/m^2 was 22 h continuous injected on d1 ,2, every 2 weeks was a cycle. It could also take capecitabine 1.0 g/m^2 or tegafur-gimeracil-oteracil potassium 25 mg/m^2 Bid for d1 - 14 orally, every 3 weeks was a treatment. Results 65 patients were evaluated. The response rates were 32.35% and 22.58%, the disease control rates were 76.47% and 70.97% , and the median progression free survival （PFS） were 5 （3. 962 - 6. 038） months and 4 （2. 730 -5. 270） months in irinoteean group and oxaliplatingroup, respectively, with no significant difference （P 〉 0.05）. Toxicity was tolerable, major adverse events were neutropenia, nausea and vomiting in two group. The incidence rate of diarrhea （45.95%） was higher in irinoteean group, and the peripheral nerve toxicity was 29.41% in oxaliplatin group. Conclusion The effects of irinoteean or oxaliplatin combined with fluoropyrimidine in the treatment of advanced gastric cancer are comparable, and their toxieities are tolerable.

关 键 词：胃肿瘤 伊立替康 奥沙利铂 氟尿嘧啶类药物 

分 类 号：R735.2[医药卫生—肿瘤]