洛铂腹腔灌注联合替吉奥治疗晚期胃癌合并腹水的临床观察  

Clinical observatioin of lobaplatin intraperitoneal combined with gimeracil and oteracil potassium capsules in treatment of advanced gastric cancer with ascites

作　　者：齐瑾[1] 郑玉军[1] 王明吉[1] 

机构地区：[1]大连市友谊医院肿瘤科,大连116001

出　　处：《中国当代医药》2014年第14期92-94,97,共4页China Modern Medicine

摘　　要：目的 观察洛铂腹腔灌注联合替吉奥治疗晚期胃癌合并腹水的疗效和安全性.方法 依照入选标准,选择经病理学确诊的老年或体力状况较差的晚期胃癌伴腹水患者30例.治疗方案：经B超定位腹腔置管,尽量放尽腹水后,洛铂30 mg/m2腹腔灌注,第1天;替吉奥口服：体表面积（BSA）＜1.25 m2者,40 mg,2次/d;BSA 1.25～1.50 m2者,50 mg,2次/d;BSA≥1.50 m2者,60 mg,2次/d,连服14 d.21 d为1个周期,2个周期后评价疗效,观察有效率、疾病控制率、生活质量改善情况及毒副反应.结果 30例患者中完全缓解0例,部分缓解12例,稳定13例,进展5例,有效率为40.0％,疾病控制率为83.3％.12例患者经1～2周期化疗后腹水全部消失,8例患者腹水明显减少,10例无明显变化.主要毒副反应为骨髓抑制、胃肠道反应及疲乏,其中骨髓抑制以白细胞减少、血小板减少、贫血为主,胃肠道反应以恶心/呕吐、腹泻为主,大多为Ⅰ～Ⅱ级,Ⅲ级及以上白细胞减少、血小板减少分别占6.7％和3.3％,无严重肝、肾毒性及心脏毒性,无手足综合征,无腹膜反应,无治疗相关性死亡.结论 洛铂腹腔灌注联合替吉奥治疗老年或体力状况较差的合并腹水的晚期胃癌效果较高,毒性作用较小,可明显改善患者的生活质量.Objective To observe the curative effect and safety of lobaplatin combined with gimeracil and oteracil potassium capsules for advanced gastric cancer with ascites.nethods Following inclusion criteria,30 cases of elderly or poor performance status patients with advanced gastric cancer with ascites who were confirmed by pathology were enrolled.And locationed by B-ultrasonic wave and given puncturing and inserting catheter,were given 30 mg/m2 lobaplatin intraperitoneal,the first day;gimeracil and oteracil potassium capsules taken orally,body surface area （BSA）〈l.25 m2, 40 rag,2 times a day;BSA 1.25-1.50 m2,50 mg,2 times a day;BSA ≥ 1.50 m2,60 mg,2 times a day,for continuous taking 14 days.21 days for a cycle.The curative effect was evaluated after 2 cycles,the response rate （RR）,disease control rate （DCR）,quality of life improvement and side reaction was observed.Results Curative effects of 30 patients were evaluat- ed.Complete remission （CR） was recorded in 0 patient,partial responses （PR） were 12 patients,no relieve （NR） were 13 patients,progression of disease were 5 patients.The RR was 40.0%,DCR was 83.3%.Ascites of 12 patients were completely disappeared and 8 patients were obviously reduced and 10 patients had no changes.The main side reactions were bone marrow depression,gastrointestinal reaction,fatigue.Leukopenia,thrombocytopenia and anemia were predominant in bone marrow depression.Nausea/vomiting and diarrhea were predominant in gastrointestinal reaction.Most were class Ⅰ to Ⅱ ,the ratio of class Ⅲ and above in leukopenia and thrombocytopenia were 6.7% and 3.3%,respectively.There was no serious liver toxicity,renal toxicity and cardiac toxicity,no hand foot syndrome,no peritoneal reaction,and no treatment related death.Conclusion Lobaplatin intraperitoneal combined with oteracil porassium capsules taking orally on advanced gastric cancer with ascites is effective,and the side reaction is low,and can improve the quality of life.

关 键 词：洛铂 腹腔灌注 替吉奥 胃癌 腹水 

分 类 号：R735.2[医药卫生—肿瘤]