卡培他滨/替吉奥维持治疗对老年晚期胃癌的临床疗效及预后分析  

Clinical efficacy of capecitabine or tegafur/gimeracil/oteracil in the maintenance treatment of elderly patients with advanced gastric cancer and prognostic analysis

作　　者：李加桩 刘晨 陈丹 张伟 隋红[2] 白玉贤[2] LI Jiazhuang;LIU Chen;CHEN Dan;ZHANG Wei;SUI Hong;BAI Yuxian(The Second Department of Oncology,the Third Affiliated Hospital of Qiqihar Medical College,Qiqihar 161000,Heilongjiang,China;The Second Department of Medicine,Affiliated Cancer Hospital of Harbin Medical University,Harbin 150040,Heilongjiang,China;Department of Medicine,Tianjin Children’s Hospital,Tianjin 300400,China)

机构地区：[1]齐齐哈尔医学院附属第三医院肿瘤二科,黑龙江齐齐哈尔161000 [2]哈尔滨医科大学附属肿瘤医院内二科,哈尔滨150040 [3]天津市儿童医院内科,天津300400

出　　处：《癌症进展》2020年第12期1262-1266,共5页Oncology Progress

基　　金：中国胃肠肿瘤临床研究协作组(CGOG)胃癌研究基金(20120101009)。

摘　　要：目的探讨老年晚期胃癌患者一线化疗后采用卡培他滨片/替吉奥维持治疗的临床疗效及预后影响因素。方法根据治疗方案的不同将90例老年晚期胃癌患者分为3组,其中,维持治疗组22例,采用紫杉醇/奥沙利铂+卡培他滨片/替吉奥胶囊一线诱导化疗后口服卡培他滨片/替吉奥胶囊维持治疗;两药化疗组53例,采用紫杉醇/奥沙利铂+卡培他滨片/替吉奥胶囊一线化疗至疾病控制后定期随访观察,直至肿瘤进展;单药化疗组15例,采用卡培他滨片/替吉奥胶囊单药化疗至疾病进展。分析老年晚期胃癌患者的无进展生存期(PFS)、总生存期(OS)及预后影响因素。结果维持治疗组、两药化疗组、单药化疗组患者的中位PFS分别为9.0、5.2和4.9个月,中位OS分别为17.0、12.0和8.1个月。3组患者的中位PFS和中位OS比较,差异均有统计学意义(P<0.05)。维持治疗组患者的常见不良反应包括血液学毒性、胃肠道反应、乏力,以1~2级为主,无治疗相关性死亡。结论卡培他滨片/替吉奥作为老年晚期胃癌患者一线化疗后的维持治疗药物,可延长患者的PFS和OS,且患者耐受性良好。Objective To observe the efficacy of capecitabine tablets or tegafur/gimeracil/oteracil(S-1)as the maintenance therapy after first-line treatment for elderly patients with advanced gastric cancer(GC),and to investigate the prognostic factors.Method According to different therapies administered,90 elderly patients with advanced GC were included and divided into three groups as maintenance therapy group(n=22),receiving paclitaxel/oxalipatin+capecitabine tablets/S-1 capsules as first-line induction chemotherapy followed by capecitabine tablets/S-1 capsules for maintenance,dual medications therapy group(n=53),accepting paclitaxel/oxalipatin+capecitabine tablets/S-1 capsules as first-line treatment to disease control,with regular follow-up till tumor progression;monotherapy group(n=15),administered with capecitabine tablets/S-1 capsules as monotherapy till disease progression.The factors influencing the progression-free survival(PFS),overall survival(OS),and prognostic factors of elderly patients with advanced GC were analyzed.Result The median PFS of maintenance treatment group,dual medications therapy group and monotherapy group was 9.0,5.2 and 4.9 months,and median OS was 17.0,12.0 and 8.1 months,respectively,there were significant differences among the three groups in terms of median PFS and median OS(P<0.05).The common adverse reactions in the maintenance group were hematological toxicities,gastrointestinal reaction and fatigue,with severity being primarily grade 1-2,and no treatment-related death occurred.Conclusion Capecitabine tablets/S-1 capsules as maintenance therapy in elderly patients with advanced GC patients after first-line chemotherapy can prolong their PFS and OS,and is well tolerated.

关 键 词：卡培他滨 替吉奥 维持治疗 胃癌 生存 

分 类 号：R735.2[医药卫生—肿瘤]