奥沙利铂联合替吉奥治疗晚期胃癌的效果

奥沙利铂联合替吉奥或卡培他滨方案用于胃癌术后疗效对比胥敏【摘要】Objective To compare the efficacy and adverse reactions of SOX and XELOX chemotherapy used after gastric cancer operation. Methods 70 cases of elderly patients with advanced gastric cancer in the hospital from January 2010 to January 2015 were randomly divided into two groups, 35 cases of SOX group, 35 cases of XELOX group. Results 70 patients were treated with 327 cycles. SOX group therapy had 167 cycles, XELOX treatment group had 160 cycles. The effectiveness of SOX and XELOX group was 62. 86%, 51. 43% respectively. The quality of life improvement rate of SOX and XELOX group was 85. 71%, 65. 71% respectively. The incidence of adverse reactions of SOX group was smaller than XELOX group. Conclusion The SOX program is more suitable than XELOX program for the treatment of elderly patients with advanced stomach cancer.%目的：观察并比较奥沙利铂联合替吉奥或卡培他滨方案在胃癌术后辅助化学治疗中的应用效果。

替吉奥联合奥沙利铂对晚期胃癌患者 TAM、CEA、CA72-4的影响刘云军;何志江;黄毅超;李文【摘要】Objective To explore the effect of tegafur combined with oxaliplatin chemotherapy on TAM ,CEA and CA72-4 of advanced gastric cancer patients and its clinical significance .Methods CEA and CA72-4 in 54 patients with gastric cancer before and after chemotherapy were detected by ELISA;serum TAM of the 54 patients were detected by biochemical methods ,and adverse reactions were analyzed .Results After 2 chemotherapy cycles ,TAM,CEA and CA72-4 levels all dropped ,and the differ-ence was statistically significant(P<0.05);the TAM,CEA and CA72-4 levels of the chemotherapy effective cases decreased sig-nificantly;but the serum TAM ,CEA and CA72-4 levels of advanced cases increased in varying degrees ,the difference was statisti-cally significant(P<0.05).Conclusion Combined detection of TAM,CEA and CA72-4 can be used as an early predictive in-dex of efficacy of advanced gastric cancer patients treated with chemotherapy .%目的：探索替吉奥联合奥沙利铂化疗对晚期胃癌TAM、CEA、CA72-4的影响及其临床意义。

替吉奥联合奥沙利铂与卡培他滨联合奥沙利铂一线治疗老年晚期胃癌的疗效分析目的比较一线替吉奥联合奥沙利铂或卡培他滨联合奥沙利铂方案治疗老年晚期胃癌患者的疗效和毒副反应。

方法采用对照临床试验，将56例经病理确诊的老年晚期胃癌患者分为治疗组30例和对照组26例；治疗组给予替吉奥联合奥沙利铂治疗，对照组使用卡培他滨联合奥沙利铂治疗。

治疗组用法：替吉奥：体表面积<1.25 m2，每日2次给药，每次为40 mg的剂量；体表面积≥1.25 m2，每日2次给药，每次为50 mg。

连续14 d，停用药物7 d，每3周重复；对照组用法：卡培他滨1000 mg/m2，每日2次，持续14 d，休息7 d，每3周重复。

两组奥沙利铂均85 mg/m2，d1，每3周重复。

化疗持续至疾病进展或出现无法耐受的毒副反应。

结果治疗组客观有效率（RR）为40%，肿瘤控制率（TGCR）为56.7 %，中位无疾病进展时间（PFS）为6.0个月，中位总生存时间（OS）为11.5个月；对照组RR 为42.3 %，TGCR为61.5%，PFS为6.3个月，OS为11.9个月。

两组疗效差异无统计学意义。

两组生存质量评分均改善，组间差异无统计学意义。

两组毒副反应均可耐受，治疗组最常见的3/4级毒副反应为血小板减少（16.6%），对照组则为中性粒细胞减少（19.2%）。

没有中性粒细胞减少性发热，没有治疗相关死亡。

结论老年晚期胃癌患者可从替吉奥联合奥沙利铂或卡培他滨联合奥沙利铂的化疗中获益，毒副反应可耐受。

卡培他滨联合奥沙利铂治疗疗效有略佳趋势。

[Abstract] Objective To compare the activity and safety of oteracil or capecitabine combined with oxaliplatin as first line therapy to treat elderly advanced gastric cancer（AGC）patients. Methods 56 elderly patients with pathologically diagnosed as advanced gastric cancer were randomly divided into a treatment group of 30 patients and a control group of 26 patients. Treatment group were given oteracil combined with oxaliplatin，while the control group were given capecitabine and oxaliplatin. The patients received oteracil at 40 mg [body surface area （BSA）<1.25 m2] or 50 mg twice a day for 14 days，followed by a 7-day rest period within a 3-week schedule in the therapy group，and capecitabine at 1000 mg/m2 twice a day for 14 days，followed by a 7-day rest period within a 3-week schedule in the control group. Oxaliplatin 85 mg/ m2 were administered on d1 every 3 weeks in both groups. Treatment was continued until disease progression or the development unacceptable toxicity. Results The therapy group were observed a response rate （RR）of 40%，a tumor growth control rate （TGCR）of 57.3%，a median progression-free-time （PFS）of 6.0 months and a median overal survival（OS）of 11.5 months. While the control group were observed a RR of 44%，a TGCR of 59.7%，a median PFS of 6.3 months and a median OS of 11.9 months. There were no significant differences in activity. In two groups，quality of life was improved and there were no significant differences between groups. The treatment was well tolerated. The most frequent grade 3 or 4 toxicities were thrombocytopenia （16.6%）for therapy group and neutropenia （19.2%）for control group. No neutropenic fever occurred. Notreatment-related deaths occurred during the research period. Conclusion Oteracil or capecitabine combined with oxaliplatin regimens in elderly patients with untreated AGC are effective. The treatment is well tolerated. The comparison of oteracil with capecitabine showed that capecitabine has a slightly higher response rate.替吉奥是由替加氟、吉美嘧啶和奥替拉西钾组成，替加氟在体内转变为5-Fu而发挥抗肿瘤作用。

替吉奥联合奥沙利铂与卡培他滨联合奥沙利铂一线治疗老年晚期胃癌目的分析替吉奥联合奥沙利铂与卡培他滨联合奥沙利铂一线治疗老年晚期胃癌的疗效。

方法方便选择该院自2012年1月—2016年6月收治的76例老年晚期胃癌，将其随机分为对照组和观察组，各38例。

对照组卡培他滨联合奥沙利铂治疗，观察组替吉奥联合奥沙利铂治疗，对比两组有效率、不良反应等。

结果观察组有效率为36.84%，对照组为31.58%；观察组临床获益率为78.95%，对照组为73.68%；观察组KPS评分改善率为81.58%，对照组为76.32%；差异无统计学意义（P>0.05）。

结论对于老年晚期胃癌患者而言，采用替吉奥联合奥沙利铂或培他濱联合奥沙利铂一线治疗均安全、有效，疗效差异无统计学意义。

[Abstract] Objective This paper tries to analyze the efficacy of S-1 combined with oxaliplatin or capecitabine combined with oxaliplatin as first-line chemotherapy in elderly patients with advanced gastric cancer. Methods 76 patients with advanced gastric cancer were convenient selected and randomly divided into the control group and the observation group，with 38 cases in each group from January 2012 to June 2016. The control group of capecitabine combined with oxaliplatin treatment，the observation group adopted S-1 combined with oxaliplatin treatment，efficiency，adverse reactions of the two groups were compared. Results The total effective rate was 36.84% in the observation group and 31.58% in the control group. The clinical benefit rate was 78.95% in the observation group and 73.68% in the control group. The improvement rate of the KPS score was 81.58% in the observation group and 76.32% in the control group，without statistical differences（P>0.05）. Conclusion For elderly patients with advanced gastric cancer，S-1 combined with oxaliplatin and capecitabine combined with oxaliplatin for first-line chemotherapy were safe and effective without significant difference.[Key words] S-1；Oxaliplatin；Capecitabine；Advanced gastric cancer；Elderly晚期胃癌患者已丧失根治性手术切除机会，治疗以化疗为主[1-2]。