多西他赛或伊立替康联合奥沙利铂及替吉奥治疗晚期胃癌的临床疗效及安全性分析  

Analysis of clinical efficacy and safety of docetaxel or irinotecan combined with oxaliplatin and S-1 in the treatment of advanced gastric cancer

作　　者：谢文健[1] 闵江[1] 钱昆[1] 张伟[1] 

机构地区：[1]重庆医科大学附属第一医院胃肠外科,重庆400016

出　　处：《重庆医学》2017年第19期2644-2648,共5页Chongqing medicine

摘　　要：目的观察多西他赛(TXT)或伊立替康(CPT-11)联合奥沙利铂(L-OHP)及替吉奥治疗晚期胃癌的临床疗效与安全性。方法收集2010年1月1日至2016年3月1日该院胃肠外科收治的符合入组条件的62例ⅢB~Ⅳ晚期胃癌患者,将其分为TXT联合L-OHP及替吉奥组(改良DCF组,33例)和CPT-11联合L-OHP及替吉奥组(改良ICF组,29例),所有患者完成1个周期及以上的化疗,直至疾病出现进展或出现不可耐受的不良反应。化疗结束后,对两组患者的疗效、不良反应,以及新辅助化疗后再行手术治疗的效果进行对比分析。结果改良DCF组的客观缓解率(ORR)为60.6%,高于改良ICF组的51.7%,但两组近期疗效比较,差异无统计学意义(Z=-0.837,P=0.403);两组胃肠道反应、骨髓抑制、神经毒性、脱发和肝功能异常等主要不良反应的发生率比较,差异均无统计学意义(P>0.05)。改良DCF组与改良ICF组新辅助化疗后再行手术治疗的根治性切除率分别为66.7%、62.1%,差异无统计学意义(χ~2=0.143,P=0.706);术后主要并发症为吻合口瘘、吻合口梗阻、腹腔感染、肺部感染、切口感染、胃动力障碍等,两组并发症的发生率比较,差异无统计学意义(P>0.05)。两组化疗后生活质量比较,差异无统计学意义(χ~2=1.572,P=0.456)。结论 TXT联合L-OHP及替吉奥与CPT-11联合L-OHP及替吉奥治疗晚期胃癌的疗效相近,可缩小瘤体,提高根治性切除率,不良反应大致相同,均可耐受,值得临床进一步研究与应用。Objective To observe the clinical efficiency and safety of docetaxel（TXT） or irinotecan（CPT-11） combined with oxaliplatin（L-OHP） and 8-1 in the treatment of advanced gastric cancer. Methods Totally 62 cases of patients with stage HI B-IV advanced gastric cancer in the Department of Gastrointestinal Surgery of our hospital were collected from 1st January 2010 to 1st March 2016,and were divided into two groups..TXT combined with L-OHP and S-1 group （modified DCF group,33 patients） and CPT-11 combined with L-OHP and S-1 group （modified ICF group,29 patients）. All patients in the two groups were completed at least 1 cycle of chemotherapy until disease progression or intolerable toxicity. At the end of chemotherapy, the curative effects, unto- ward reactions and effects of surgery after neoadjuvant chemotherapy treatment were compared and analyzed. Results The objective response rate （ORR） in the modified DCF group（60.6%） was higher than that in the modified ICF group （51.7%） ,while no sta- tistically significant difference was found in short-term effects between the two groups （Z=-0. 837 ,P=0. 403）. There was no sta tistically significant difference in the incidences of main untoward reactions, including gastrointestinal reaction, myelosuppression, neurotoxicity,alopecia and liver function abnormal, between the two groups （P〉O. 05）. The radical resection rate of the modified DCF group and the modified ICF group after neoadjuvant chemotherapy was 66.7 % and 62. l% respectively, the difference between the two groups was not statistically significant （X^2 = 0. 143, P= 0. 706）. After neoadjuvant chemotherapy, the main postoperative complications were anastomotic leakage, anastomotic obstruction, abdominal infection, pulmonary infection, incision infection and gastric motility disorder, and no statistically significant difference was found in the incidence of postoperative complications between the two groups （P〉0.05）. The was no statistically significant difference in q

关 键 词：胃肿瘤 晚期 多西他赛 伊立替康 奥沙利铂 替吉奥 新辅助化疗 治疗效果 

分 类 号：R735.2[医药卫生—肿瘤]