雷替曲塞联合奥沙利铂治疗晚期贲门癌的疗效  

Clinical observation of raltitrexed with oxaliplantin in treatment of advanced gastric cardial carcinoma

作　　者：吕会来[1] 温士旺[1] 李勇[1] 张月峰[1] 徐延昭[1] 李振华[1] 朱永刚[1] 田子强[1] 

机构地区：[1]河北医科大学第四医院胸外五科,河北石家庄050091

出　　处：《现代肿瘤医学》2016年第4期555-558,共4页Journal of Modern Oncology

基　　金：河北省医学科学研究重点课题计划(编号:20150303)

摘　　要：目的:观察雷替曲塞联合奥沙利铂与氟尿嘧啶/左亚叶酸钙联合奥沙利铂治疗晚期贲门癌的疗效和毒副反应。方法:将92例研究病例分为试验组与对照组,每组46例,试验组给予雷替曲塞2.5mg/m^2,15min内静脉滴注,第1天;联合奥沙利铂130mg/m^2,静脉滴注>3小时,第1天。对照组给予奥沙利铂130mg/m^2,第1天;左亚叶酸钙200mg/m^2,静脉滴注2小时,5-氟尿嘧啶500mg/m^2,第1~5天静脉滴注,每3周为1个周期,每2个周期后评价疗效及毒副反应,最多化疗6个周期。结果:全组92例均可评价疗效及不良反应,其中试验组有效率56.5%,临床获益率78.3%,中位生存期10.9个月;对照组有效率60.9%,临床获益率82.6%,中位生存期11.5个月。两组有效率、临床获益率和中位生存期均无统计学差异。在不良反应方面,两组均有不同程度的骨髓抑制反应,其中Ⅰ-Ⅳ级发生率相比差异无统计学意义(P>0.05),Ⅲ-Ⅳ级发生率相比差异有统计学意义(P<0.05);实验组较对照组在胃肠道反应及静脉炎等不良反应方面的发生率均低,有显著性差异(P<0.05);两组在神经毒性、转氨酶异常及其他化疗反应的发生率上无显著性差异(P>0.05);所有病例均无化疗相关性死亡。结论:雷替曲塞联合奥沙利铂方案治疗晚期贲门癌的有效率和中位生存时间与氟尿嘧啶/亚叶酸钙联合奥沙利铂方案相当,部分毒副反应轻,发生率低且可耐受,不用亚叶酸钙增效,值得在临床上推广应用。Objective： To evaluate the effect and security of raltitrexed with oxaliplatinl in the treatment of advanced gastric cardial carcinoma. Methods： A total of 92 patients with advanced gastric cardial carcinoma were randomized into raltitrexed plus oxaliplatin regimen group（ treatment group： raltitrexed 2. 5mg / m2,15 minutes,intravenous bolus,d1,combined oxaliplantin 130mg/m2,intravenous infusion 〉3h,d1,21 days as a cycle） and fluorouracil/leucovorin plus oxaliplatin regimen group（ control group： oxaliplatin 130 mg / m2 over 2 hours,infusion on d1,leucovorin200 mg / m^2 infusion over 2 hours and 5-fluorouracil 500 mg / m2d1~ d5,the regimen was repeated every 21 days as a cycle）. A total of six cycles was applied unless there was evidence of disease progression or intolerance of treatment.The efficacy was evaluated after every 2 cycles of chemotherapy. Results： All 92 patients were evaluable. There was no significant difference between treatment and control group in overall response rate（ 56. 5% vs 60. 9%,P〉0. 05）,disease control rate（ 78. 3% vs 82. 6%,P〈0. 05） and the middle survival time（ 1 0. 9 months vs 1 1. 5 months,P〉0. 05）. 2 groups had different levels of myelosuppression,including grade Ⅰ-Ⅳ with no significant difference（ P〉0. 05）,Ⅲ-Ⅳ levels was significantly difference（ P〈0. 05）. Treatment group had lower frequencies of toxicity in gastrointestinal reactions（ P〈0. 05）,and phlebitis（ P〈0. 05）. There was no statistic difference between two groups in other side effects such as aminotransferase abnormality,peripheral neurotoxicity and so on. The whole group had no treatment-related death. Conclusion： There is no difference in median overall survival time and the clinical efficacy of raltitrexed plus oxaliplatin with fluorouracil / leucovorin plus oxaliplatin. Compared with traditional FU-based regimen,patients are with acceptable tolerability and convenient administration schedule without leucovorin efficiency.Raltitrexed combined with oxa

关 键 词：雷替曲塞 奥沙利铂 晚期贲门癌 疗效评价 

分 类 号：R735.2[医药卫生—肿瘤]