奥沙利铂联合希罗达或替吉奥一线化疗并序贯维持治疗晚期胃癌的临床研究  

Clinical research of Oxaliplatin combined with Xeloda or S-1 as first-line chemotherapy and sequential maintenance therapy for advanced gastric cancer

作　　者：赵玲琳 李国元[2] ZHAO Linglin;LI Guoyuan(Department of Emergency,Qinghai People′s Hospital,Xining,Qinghai 810007,China;Departmentof Medical Oncology,Affiliated Hospital of Qinghai University,Xining,Qinghai 810001,China)

机构地区：[1]青海省人民医院急诊内科,西宁810007 [2]青海大学附属医院肿瘤内科,西宁810001

出　　处：《重庆医学》2019年第12期2018-2022,共5页Chongqing medicine

基　　金：青海大学附属医院中青年基金(ASRF-2010-07)

摘　　要：目的比较奥沙利铂+希罗达(XELOX方案)与奥沙利铂+替吉奥(SOX方案)一线化疗并序贯维持治疗晚期胃癌的疗效。方法选取2016年1月至2017年12月青海省人民医院收治的符合纳入标准的Ⅳ期初治胃癌患者共129例,根据治疗方法分为XELOX方案组(n=62)和SOX方案组(n=67),每2个化疗周期评价疗效,回顾性分析每组患者的有效率(RR)、疾病控制率(DCR)及不良反应。一线化疗后达到疾病控制的患者99例,有21例继续希罗达维持(希罗达维持组),23例替吉奥维持(替吉奥维持组)治疗,55例观察病情,观察两组维持治疗的RR、DCR组及不良反应,随访99例患者的无疾病进展期(PFS)、总生存期(OS)。结果XELOX组和SOX组的RR与DCR比较差异无统计学意义(P>0.05)。一线化疗达疾病控制后序贯维持治疗,两组维持治疗的疗效基本相当(P>0.05)。XELOX组与SOX组一线化疗及序贯维持治疗的不良反应大多为Ⅰ~Ⅱ度,Ⅲ~Ⅳ度发生率较低,手足综合征的发生率在XELOX组及希罗达维持组更高(P<0.05)。XELOX组与SOX组比较,两组的PFS及OS比较差异无统计学意义(P>0.05);希罗达维持组与替吉奥维持组比较,两组PFS及OS比较差异无统计学意义(P>0.05);维持治疗患者与未维持治疗患者的PFS比较差异有统计学意义(P<0.05),但OS差异无统计学意义(P>0.05)。结论一线应用XELOX与SOX方案治疗晚期胃癌并序贯希罗达、替吉奥维持治疗的疗效基本相当,不良反应均可耐受。Objective To compare the efficacy between Oxaliplatin combined with Xeloda (XELOX regimen) and Oxaliplatin combined with S-1 (SOX regimen) as first-line chemotherapy and sequential maintenance therapy for advanced gastric cancer.Methods A total of 129 initial gastric cancer patients in phase Ⅳ met the inclusion criteria in Qinghai People′s Hospital from January 2016 to December 2017 were selected.According to treatment regimen,patients were divided into the XELOX group ( n =62) and the SOX group ( n =67).Efficacy was evaluated every 2 cycles of chemotherapy,the effective rate (RR),disease control rate (DCR) and adverse reactions of each group were retrospectively analyzed.Among the 99 patients who achieved the disease control after first-line chemotherapy,there were 21 patients who continued Xeloda for maintenance (the Xeloda maintenance group),23 patients continued S-1 for maintenance (the S-1 maintenance group),and 55 patients were observed.RR,DCR and adverse reactions of the 2 maintenance groups were observed.A total of 99 patients were followed up with disease progression free (PFS),overall survival (OS).Results There was no significant difference in RR and DCR between the XELOX group and the SOX group ( P >0.05).After first-line chemotherapy achieved disease control and sequential maintenance therapy continued,the maintenance efficacy of two groups was basically equal ( P >0.05).The adverse reactions of chemotherapy and sequential maintenance therapy in the XELOX group and the SOX group were mostly degree Ⅰ-Ⅱ,few degree Ⅲ-Ⅳ.The incidence of hand-foot syndrome was higher in the XELOX group than that in the Xeloda maintenance group ( P <0.05).While the XELOX group was compared with the SOX group,there was no significant difference in PFS and OS ( P >0.05).While the Xeloda maintenance group was compared with the S-1 maintenance group,there was no significant difference in PFS and OS( P > 0.05 ).There was statistically significant difference in PFS between the maintenance group and un-maintenance gro

关 键 词：胃肿瘤 晚期胃癌 一线化疗 维持化疗 XELOX SOX 

分 类 号：R735.2[医药卫生—肿瘤]