DCF方案一线化疗后替吉奥维持治疗晚期胃癌  

Effect of S-1 maintenance chemotherapy following DCF regimen in patients with advanced gastric cancer

作　　者：陈敬华[1,2] 申维玺 夏俊贤[1,2] 许瑞莲 朱美琴[1,2] 徐敏 

机构地区：[1]暨南大学第二临床医学院 [2]深圳市人民医院肿瘤内科,广东深圳518020

出　　处：《南方医科大学学报》2014年第7期1057-1060,共4页Journal of Southern Medical University

摘　　要：目的：探讨晚期胃癌DCF方案一线化疗后继续替吉奥维持化疗疗效及不良反应。方法随机将60例既往DCF方案一线化疗4~6周期后疗效评价为无疾病进展的晚期胃癌患者分为维持组与对照组。维持组予替吉奥维持化疗（40 mg/m2，连续14 d，每21 d为一个周期），持续至疾病进展或者出现不能耐受毒性为止。对照组予最佳支持治疗。结果维持组的近期有效率（CR＋PR）为33.3%，疾病控制率（CR＋PR＋SD）为73.3%，对照组的近期有效率为3.33%，疾病控制率为46.7%，两组比较差异有统计学意义（P〈0.05）。维持组的中位疾病进展时间7.9月，较对照组6.8月延长（P〈0.05）。两组中位生存期分别为13.8月和11.7月（P〉0.05）。维持组主要毒副反应为恶心、呕吐、白细胞减少、手足综合征，无治疗相关死亡。结论 DCF方案一线治疗后继续替吉奥维持治疗晚期胃癌患者，提高近期有效率及疾病控制率，延缓疾病进展，不良反应可以耐受，值得临床进一步研究应用。Objective To investigate the efficacy and adverse effect of DCF regimen with subsequent S-1 maintenance chemotherapy in patients with advanced gastric cancer （AGC）. Methods Sixty AGC patients without disease progression after 4 to 6 cycles of DCF regimen as the first-line chemotherapy were randomized into maintenance group and control group （30 patients each）. The patients in the maintenance group received maintenance chemotherapy with S-1 （40 mg/m2, twice daily for 14 days; 21 days for a treatment cycle） until disease progression or with intolerant toxicity, and those in the control group received optimal supportive care. Results The response rate （CR＋PR） was 33.3%in the maintenance group, significantly higher than that in the control group （3.33%, P〈0.05）, and the disease control rate （CR＋PR＋SD） also differed significantly between the two groups （73.3% vs 46.7%, P〈0.05）. The median time to progression was 7.9 months in the maintenance group and 6.8 months in the control group, with median overall survival time of 13.8 and 11.7 months, respectively （P〉0.05）. The most common adverse effect in the maintenance group included nausea, vomiting, leucocytopenia, and hand-foot syndrome; no death occurred in relation to the therapy. Conclusions S-1 maintenance chemotherapy, with a tolerable toxicity profile, can improve the RR, DCR and median time to progression in AGC patients who respond to DCF regimen, but its efficacy still awaits further evaluation.

关 键 词：晚期胃癌 替吉奥 维持化疗 

分 类 号：R735.2[医药卫生—肿瘤]