奥沙利铂、亚叶酸钙、替加氟联合用药治疗晚期胃癌的临床疗效和毒副作用分析  

Clinical Efficacy and Side Effects of Oxaliplatin,Calcium Folinate and Tegafur in the Treatment of Advanced Gastric Cancer

作　　者：王海荣[1] 梁金秋[1] Wang Hairong;Liang Jinqiu(No.2 Cancer Department of Suining Central Hospital,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院肿瘤二病区,四川遂宁629000

出　　处：《四川医学》2018年第9期1070-1074,共5页Sichuan Medical Journal

摘　　要：目的奥沙利铂、亚叶酸钙、替加氟联合用药治疗晚期胃癌的短期临床疗效,并分析两种FOLFOX4方案对患者具体毒副作用的差异。方法将符合研究要求的晚期胃癌患者114例按照对象治疗意愿,结合人口学资料匹配分组的方法均分为A组和B组,分别给予不同化疗药物的联合给药,比较两组患者治疗后近期疗效和毒副作用(血液系统、消化系统、泌尿系统、神经系统、心脏功能)的具体差异。结果两组患者近期疗效的差异有统计学意义(X^2=16. 696,P=0. 001);血液系统毒副反应的比较,其血红蛋白(X^2=28. 782,P=0. 000)、白细胞(X^2=33. 727,P=0. 000)、粒细胞(X^2=9. 531,P=0. 000)、血小板(X^2=33. 250,P=0. 000)、皮下出血情况(X^2=39. 740,P=0. 000)构成的差异均有统计学意义;系统毒副反应的比较,胆红素异常(X^2=6. 054,P=0. 000)、谷丙转氨酶异常(X^2=12. 711,P=0. 013)、碱性磷酸酶(X^2=4. 073,P=0. 044)、口腔(X^2=10. 218,P=0. 000)、恶心呕吐(X^2=13. 910,P=0. 000)、腹泻(X^2=17. 672,P=0. 000)构成的差异有统计学意义;泌尿系统的尿素氮(=4. 154,P=0. 000)、肌酐(X^2=13. 611,P=0. 000)、血尿(X^2=3. 145,P=0. 000)、感染(=5. 568,P=0. 000);而蛋白尿(=2. 573,P=0. 632)构成的差异无统计学意义;神经系统的神志(X^2=9. 722,P=0. 000)、周围神经(X^2=6. 133,P=0. 000)、便秘(X^2=1. 590,P=0. 000)、疼痛(X^2=11. 342,P=0. 000)构成的差异有统计学意义;心功能比较,心脏节律(X^2=6. 990,P=0. 000)、心功能(X^2=2. 612,P=0. 015)、心包炎(X^2=1. 148,P=0. 000)构成的差异统计学意义(P<0. 05)。结论奥沙利铂、亚叶酸钙、替加氟联合用药治疗晚期胃癌的短期临床疗效显著,并且通过FOLFOX4方案(第1d奥沙利铂130mg/m2静滴2h;第1d和第2d,亚叶酸钙200mg/m2,静滴2h;第1～5d,5-氟尿嘧啶500mg/m2,静滴4h)的组合方式进行治疗的毒副作用相对较小。Objective To eXplore the short-term clinical efficacy of oXaliplatin,calcium folinate and tigafur in the treatment of advanced gastric cancer,and to analyze the difference of specific side effects of two FOLFOX4 regimens in patients with advanced gastric cancer.Methods 114 patients with advanced gastric cancer who met the requirements of the study were divided into two groups according to the patients’ wishes and demographic data： group A and group B. The patients in the two groups were given combined administration of different chemotherapeutic drugs,respectively. After treatment,the short-term efficacy and side effects（ blood system,digestive system,urinary system,nervous system,heart function） were compared between the two groups.Results The difference of short-term curative effect between the two groups was statistically significant（X^2 = 16. 696,P = 0. 001）;There were significant differences in hemoglobin（ X^2= 28. 782,P = 0. 000）,white blood cell（ X^2= 33. 727,P = 0. 000）,granulocyte（ X^2= 9. 531,P= 0. 000）,platelets（ X^2= 33. 250,P= 0. 000） and subcutaneous hemorrhage（ X^2= 39. 740,P= 0. 000） in the blood system; For the digestive system,the differences of the side effects of abnormal bilirubin（ X^2= 6. 054,P = 0. 000）,alanine aminotransferase（ X^2= 12. 711,P = 0. 013）,alkaline phosphatase（ X^2= 4. 073,P = 0. 044）,oral cavity（ X^2= 10. 218,P = 0. 000）,nausea and vomiting（ X^2= 13. 910,P = 0. 000）,diarrhea（ = 17. 672,P = 0. 000） were significantly different; The differences in urinary nitrogen（ X^2= 4. 154,P = 0. 000）,creatinine（ X^2= 13. 611,P = 0. 000）,hematuria（ X^2= 3. 145,P = 0. 000） and infection（ X2 = 5. 568,P =0. 000） were statistically significant,but the difference in proteinuria（ = 2. 573,P = 0. 632） was not statistically significant; The differences of consciousness（ X^2= 9. 722,P = 0. 000）,peripheral nerve（ X^2= 6. 133,P = 0. 000）,constipation（ X^2= 1. 590,P =0. 000）,and pain（ X^2= 11. 342,P = 0. 000） we

关 键 词：胃癌 晚期 奥沙利铂 化疗 毒副作用 

分 类 号：R735.2[医药卫生—肿瘤]