不同一线化疗方案治疗老年晚期胃癌的近期临床疗效观察  

Efficacy of first-line chemotherapeutic regimens in the treatment of elderly advanced gastric cancer

作　　者：张秋杰[1] 赵海波[1] 于清清 ZHANG Qiujie;ZHAO Haibo;YU Qingqing(Department of Oncology,Jining No.1 People's Hospital,Jining,Shandong,272000,China)

机构地区：[1]济宁市第一人民医院肿瘤科,山东济宁272000

出　　处：《肿瘤药学》2021年第6期743-747,共5页Anti-Tumor Pharmacy

基　　金：山东省医药卫生科技发展计划基金(2017WS347)。

摘　　要：目的比较不同一线化疗方案治疗老年晚期胃癌的近期疗效及不良反应。方法选择2017年1月1日—2019年12月31日我院收治的111例老年晚期HER-2阴性胃癌患者为研究对象,所有患者均经病理组织学或细胞学确诊。其中65例患者采用SOX方案:奥沙利铂130 mg·m^(-2)静脉滴注,d1+替吉奥80 mg·m^(-2)·d^(-1)口服,bid,d1-d14,21 d为1个周期;46例患者采用TS方案:多西紫杉醇75 mg·m^(-2)静脉滴注,d1+替吉奥80 mg·m^(-2)·d^(-1)口服,bid,d1-d14,21 d为1个周期。所有患者均连续治疗2个周期以上。评价并比较两组患者的近期疗效和不良反应。结果SOX组客观有效率(ORR)为55.38%(36/65),疾病控制率(DCR)为84.62%(55/65);TS组ORR为52.17%(24/46),DCR为89.13%(41/46);TS组DCR略高于SOX组,但差异无统计学意义(P>0.05)。两组患者的不良反应主要为骨髓抑制和胃肠道反应,SOX组1~2级贫血的发生率高于TS组,差异有统计学意义(72.31%vs.43.48%,P=0.002)。SOX组和TS组的无进展生存期(PFS)分别为(6.9±2.9)个月、(8.2±3.7)个月,差异有统计学意义(P=0.040);总生存期(OS)分别为(13.9±5.7)个月、(13.3±5.9)个月,差异无统计学意义(P>0.05)。结论与SOX方案相比,TS方案一线治疗老年胃癌的近期疗效相似,不良反应发生率较低,患者PFS显著延长,在老年晚期胃癌的治疗中更具优势。Objective To compare the short-term efficacy and adverse reactions of different first-line chemotherapeutic regimens in the treatment of elderly advanced gastric cancer.Methods A total of 111 elderly advanced gastric cancer patients without HER-2 mutation admitted to our department between January 1,2017 and December 31,2019 were selected in the study.All patients were diagnosed as advanced gastric cancer by histopathology or cytology.Sixty-five patients got SOX regimen:oxaliplatin 130 mg·m^(-2) d1+S-180 mg·m^(-2)·d^(-1) bid d1-14,21 days as one cycle.Forty-six patients got TS regimen:docetaxel 75 mg·m^(-2) d1+S-180 mg·m^(-2)·d^(-1) bid d1-14,21 days as one cycle.All patients got more than two consecutive cycles.The short-term effects were evaluated and the adverse reactions were graded.Results The objective response rate(ORR)of SOX group was 55.38%(36/65),and the disease control rate(DCR)was 84.62%(55/65);the ORR of TS group was 52.17%(24/46),and the DCR was 89.13%(41/46).The DCR of TS group was slightly higher than SOX group,but with no statistical difference(P>0.05).The main adverse reactions of the two groups were myelosuppression and gastrointestinal reactions.The incidence rate of grade 1~2 anemia in the SOX group was higher than in the TS group,and the difference was statistically significant(72.31%vs.43.48%,P=0.002).The PFS was(6.9±2.9)months in the SOX group,and(8.2±3.7)months in the TS group,and there was statistical difference between the two groups(P=0.040).There was no statistical difference in the OS between the two groups[(13.9±5.7)months vs.(13.3±5.9)months,P>0.05].Conclusion For elderly patients with advanced gastric cancer,TS regimen had equal efficacy to SOX regimen,lower incidence rate of adverse reactions and longer PFS than SOX regimen.TS regimen may be a more appropriate treatment for elderly patients with advanced gastric cancer.

关 键 词：高龄 胃癌 多西紫杉醇 奥沙利铂 替吉奥 

分 类 号：R735.2[医药卫生—肿瘤]