晚期胃癌二线使用EOX和FOLFIRI方案化疗的疗效及安全性评价  

Efficacy and safety of second-line chemotherapy with EOX and FOLFIRI in advanced gastric cancer

作　　者：沈玲[1] 罗波 SHEN Ling;LUO Bo(Department of Oncology,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000;School of Combined TCM and Western Medicine,Southwest Medical University,Luzhou 646000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院肿瘤内科,河南南阳473000 [2]西南医科大学中西医结合学院,四川泸州646000

出　　处：《西安交通大学学报（医学版）》2018年第4期546-550,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：河南省医学科技攻关计划项目(No.201403026)~~

摘　　要：目的探讨二线使用EOX(表阿霉素+奥沙利铂+卡培他滨)治疗晚期胃癌的疗效及安全性。方法收集2010年1月1日至2013年6月1日我院收治的107例DCF方案化疗失败后的晚期胃癌患者,采用随机数字表法随机分为EOX组(n=56)和FOLFIRI组(5-Fu+伊立替康,n=51)。观察并记录有效率(RR)、疾病控制率(DCR)、疾病无进展生存期(PFS)、总生存期(OS)和不良反应。结果 EOX组RR为28.57%,FOLFIRI组RR为25.49%,两组差异无统计学意义(P>0.05);EOX组DCR为73.21%,FOLFIRI组DCR为66.67%,两组差异无统计学意义(P>0.05)。EOX组与FOLFIRI组的中位疾病无进展时间(mPFS)分别为7.4个月和8.1个月(χ~2=0.547,P=0.460),中位总生存期(mOS)分别为19.3个月和18.5个月(χ~2=1.886,P=0.170)。两组患者在化疗过程中不良反应主要表现为白细胞减少、血小板减少、贫血、恶心/呕吐、手足综合征、口腔炎、外周神经毒性,主要为Ⅰ~Ⅱ级。FOLFIRI组中性粒细胞减少、血小板减少、贫血、腹泻的发生率均显著高于EOX组(P<0.05),而外周神经毒性发生率低于EOX组(P<0.05)。结论 EOX化疗方案治疗经DCF一线化疗失败后的进展期晚期胃癌患者有较高的疾病控制率及远期生存率,患者总体耐受性良好,值得临床进一步研究。Objective To study the clinical efficacy and safety of the regimen of oxaliplatin plus epirubicin and capecitabine（EOX）as the second-line treatment for advanced gastric cancer.Methods We randomly divided107 patients with advanced gastric cancer for treatment between January 1,2010 and June 1,2013 in our hospital after DCF chemotherapy failed into EOX group（n=56）and FOLFIRI group（n=51）.We observed the response rate（RR）,disease control rate（DCR）,time to progression（PFS）,overall survival（OS）and adverse reactions in the two groups.Results RR in EXO group and FOLFIRI group was 28.57% and 25.49%,respectively,without significant difference（P〉0.05）.DCR in EXO group and FOLFIRI group was 73.21% and 66.67%,without significant difference（P〉0.05）.The median progression-free time（mPFS）in EOX group and FOLFIRI group was7.4 months and 8.1 months（χ^2=0.547,P=0.460）,and the median overall survival（mOS）was 19.3 months and18.5 months（χ^2=1.886,P =0.170）.The mainly side effects associated with the regimen were leukopenia,thrombocytopenia,anemia,nausea/vomiting,hand-foot syndrome,stomatitis,and peripheral neurotoxicity.Neutropenia,thrombocytopenia,anemia,and diarrhea in EOX group were more frequent than those in FOLFIRI group（P〈0.05）.Conclusion The regimen based on EOX is effective in patients with advanced gastric cancer after DCF chemotherapy failed and the toxicities are tolerable.

关 键 词：晚期胃癌 FOLFIRI EOX 二线化疗 疗效 安全性 

分 类 号：R735.2[医药卫生—肿瘤]