紫杉醇、奥沙利铂联合氟尿嘧啶方案与S1+奥沙利铂方案在治疗进展期胃癌中的疗效对比研究  

Efficacy and safety of TOF and SOX regimens in the treatment of advanced gastric cancer

作　　者：戴夕超[1] 张西志[1] 汪步海[1] 袁一枫[1] 王朝敏[1] 陈苏平[1] 张先稳[1] 陈丽[1] 蒋亚齐[1] 

机构地区：[1]江苏省苏北人民医院肿瘤科,江苏扬州225001

出　　处：《实用临床医药杂志》2013年第21期66-68,76,共4页Journal of Clinical Medicine in Practice

摘　　要：目的比较紫杉醇、奥沙利铂联合氟尿嘧啶方案与S1十奥沙利铂方案在治疗晚期胃癌中的临床疗效和安全性。方法选取60例经组织或细胞病理学证实的晚期胃癌患者，随机分为紫杉醇、奥沙利铂联合氟尿嘧啶组（TOF组）和s1十奥沙利铂组（S0x组），每组30例。TOF组治疗方案为：紫杉醇135mg/m2，第1天，使用前按照说明书要求进行预处理；氟尿嘧啶500rng／m2，化疗泵持续静脉滴注，第1～5天；奥沙利铂100mg／m2，静脉滴注2h，第1天。SOX组治疗方案为：替吉奥胶囊根据体表面积给药，体表面积〈1．25m2，40mg，2次／d；体表面积125～1．50m2，50mg，2次／d；体表面积〉1．50m2，60mg，2次／d，早晚餐后口服，第1～14天；停药7d；奥沙利铂130mg／m2静脉滴注，第1天，21d为一个周期。2个周期后评价疗效并记录毒副作用。结果TOF组客观缓解率为43．3％，疾病控制率为60％，中位无进展生存（PFS）时间为6．5个月；S0x组客观缓解率为36．7％，疾病控制率为56．7％，中位无进展生存（PFS）时间为5．8个月。2组客观缓解率和疾病控制率比较差异无统计学意义。TOF组最常见的不良反应是骨髓抑制、恶心呕吐、口腔黏膜炎，SOX组主要为骨髓抑制。TOF组的不良反应发生率较SOX组更高。结论两种方案治疗进展期胃癌均有成效，紫杉醇、奥沙利铂联合氟尿嘧啶方案不良反应更大，但患者均可耐受。Objection To compare the efficacy and safety of TOF and SOX in the treat- ment of advanced gastric cancer. Methods Sixty histopathologically - confirmed patients with ad- vanced gastric cancer were included in the study and were randomly divided into paclitaxel, oxali- platin combined with fluorouracil group （TOF group, n = 30） and S1 ＋ oxaliplatin group （SOX group, n = 30）. The treatment regimen for TOG group was as follows： paclitaxel 135 mg/m2, pretreatment was done in accordance with the specifications on day 1; fluorouracil 500 mg/m2, chemotherapy pump？ intravenous drip from day 1 to day 5; oxaliplatin 100 mg/m2, intravenous drip on day 1. The treatment regimen for SOX group was as follows： S1 capsule was administered according to body surface area, body surface areaK 1.25 m2, 40 rag, 2 times/d; body surface area between 1.25 and 1.50 m2, 50 mg, 2 time/d; body surface area〉1.50 m2, 60 mg, 2 times/d, o- ral intake before breakfast and dinner from day 1 to day 14; medication ceased for 7d; oxaliplatin 130 mg/m2 intravenous drip on day 1, 21 days as a cycle. Efficacy was evaluated and adverse reac- tions of toxicity were recorded after two cycles. Results In TOF group and SOX group, the re- sponse rates were 43.3 % and 36.7 %, and tumor control rates were 60 % and 56.7 %, respective- ly. The median progression - free survival was 6.5 months and 5.8 months for TOF and SOX, re- spectively. Difference between the two groups was not statistically significant. In TOF group, the main adverse reactions were bone marrow depression, vomit and mucositis, while in SOX group,the main adverse reactions were bone marrow depression. Incidence rate of adverse reactions was higher in TOF group than in SOX group. Conclusion Both regimens offer effective tumor growth control in patients with advanced gastric cancer. There are more adverse reactions rising from aclitaxel, oxaliplatin combined with fluorouracil regimen, but they are well tolerated by pa- tients.

关 键 词：进展期胃癌 紫杉醇 奥沙利铂 氟尿嘧啶 S1+奥沙利铂 

分 类 号：R735.2[医药卫生—肿瘤]