多西他赛联合替吉奥与奥沙利铂联合替吉奥一线治疗晚期胃癌的疗效分析(1)
【摘要】 目的：评价多西他赛联合替吉奥与奥沙利铂联合替吉奥在晚期胃癌中的疗效和安全性。方法：回顾分析并比较本院2012年1月-2015年1月54例经病理确诊的晚期胃癌患者分别应用多西他赛联合替吉奥与奥沙利铂联合替吉奥方案的疗效和安全性，TS组28例应用多西他赛联合替吉奥方案，OS组26例应用奥沙利铂联合替吉奥方案，比较两组患者的疾病缓解率、疾病控制率和中位无疾病进展时间(median progression-free surviva，PFS)，同时比较两组化疗过程中的Ⅲ度和Ⅳ度不良反应的发生率。结果：TS组和OS组的疾病缓解率分别为57.14%和61.54%(P=0.745)，疾病控制率分别为85.71%和84.62%(P=0.910)，mPFS分别为7.8个月和8.4个月(P=0.531)；两组Ⅲ度和Ⅳ度不良反应的发生率分别为14.29%和19.23%(P=0.626)，比较差异均无统计学意义(P>0.05)。结论：TS方案和OS方案均是胃癌有效的一线化疗方案，不良反应可耐受，疗效和不良反应无明显差异，临床上均可推荐使用。
【关键词】 胃癌； 替吉奥； 多西他赛； 奥沙利铂
Analysis of Efficacy of Tegafur Gimeracil Oteracil Potassium Capsule Combined with Docetaxel and Tegafur Gimeracil Oteracil Potassium Capsule with Oxaliplatin in Fist Line Treatment for Advanced Gastric Cancer/AI Bi，CHEN Limei，FANG Ke.//Medical Innovation of China，2017，14(32)：050-053
【Abstract】 Objective：To evaluate the efficacy and safety of tegafur gimeracil oteracil potassium capsule combined with docetaxel and tegafur gimeracil oteracil potassium capsule combined with oxaliplatin in fist line treatment with advanced gastric cancer.Method：Retrospective analysis and comparison of the efficacy and safety of the two chemotherapy regimens in 54 advanced gastric cancer patients，who were pathological diagnosed in our hospital from January 2012 to January 2015.28 cases in TS group treated with tegafur gimeracil oteracil potassium capsule and docetaxel，26 cases in OS group treated with tegafur gimeracil oteracil potassium capsule combined with oxaliplatin.The disease remission rate，control disease rate，mPFS and the incidence of Ⅲ and Ⅳ stage adverse effects in the two groups were compared.Result：In TS and OS group，the disease remission rate were 57.14% and 61.54% (P=0.745)，the control rate of disease were 85.71% and 84.62% (P=0.910)，mPFS were 7.8 months and 8.4 months(P=0.531)；the incidence of adverse reactions of Ⅲ stage and Ⅳ stage in the two groups were 14.29% and 19.23%(P=0.626)，there were no significant difference between the two groups(P>0.05).Conclusion：TS and OS regimens are effective and safe fist-line chemotherapy for advanced gastric cancer，adverse reactions can be tolerated，their are no significant differences in efficacy and adverse reactions.They are recommended in clinical practice.
【Key words】 Gastric cancer； Tegafur gimeracil oteracil potassium capsule； Paclitaxel； Oxaliplatin
First-author’s address：Yingtan People’s Hospital，Yingtan 335000，China
doi：10.3969/j.issn.1674-4985.2017.32.012
在世界范圍内，癌症相关死亡率中，胃癌排在第二位[1]。胃癌早期症状不明显，加之患者就诊意识不强，大部分患者确诊时已属于进展期，其中大部分已有转移，失去手术机会，严重影响了胃癌患者的预后。特别是晚期不可手术和复发的患者，5年生存率<5%[2]。晚期胃癌的主要治疗方法仍然是化疗，可以明显延长患者生存时间，改善生活质量[3]。一线化疗可供选择的方案较多，主要的有效药物有铂类：顺铂和奥沙利铂；紫杉类：紫杉醇和多西紫杉醇；氟尿嘧啶类：5-FU、卡培他滨和替吉奥；蒽环类和伊立替康等[4]。单药有效率低，目前临床常用的方案为两药联合方案，三药联合方案较两药联合方案有效率高[5]，但由于不良反应较大，中国人群耐受性差[6]，国内少用，欧洲应用较为广泛[7]。5-FU类药物是晚期胃癌的基础用药[8]，替吉奥是20世纪90年代由日本大鹏药品研发的口服5-FU前体药物，已称为日本胃癌治疗的一线用药[9]。在SPIRITS试验中确立了顺铂联合替吉奥可以作为晚期胃癌的一线化疗方案[10]，中位生存时间为13.0个月，显著优于替吉奥单药的11.0个月。奥沙利铂是第三代铂类药物，不良反应较顺铂小，在胃癌中可替代顺铂[11]。多西他赛也是胃癌中的有效药物，单药的有效率为20%～28%[12]，在日本的一项Ⅱ期临床研究显示多西他赛每周方案联合小剂量替吉奥有效率达到52.3%，中位生存时间16.0个月，超过了以往的晚期胃癌的一线化疗方案[13]。本文回顾分析本院2012年1月-2015年1月，54例经病理确诊的晚期胃癌患者应用多西他赛联合替吉奥与奥沙利铂联合替吉奥方案的疗效，现报道如下。, 百拇医药(艾碧 陈丽梅 方科)
【关键词】 胃癌； 替吉奥； 多西他赛； 奥沙利铂
Analysis of Efficacy of Tegafur Gimeracil Oteracil Potassium Capsule Combined with Docetaxel and Tegafur Gimeracil Oteracil Potassium Capsule with Oxaliplatin in Fist Line Treatment for Advanced Gastric Cancer/AI Bi，CHEN Limei，FANG Ke.//Medical Innovation of China，2017，14(32)：050-053
【Abstract】 Objective：To evaluate the efficacy and safety of tegafur gimeracil oteracil potassium capsule combined with docetaxel and tegafur gimeracil oteracil potassium capsule combined with oxaliplatin in fist line treatment with advanced gastric cancer.Method：Retrospective analysis and comparison of the efficacy and safety of the two chemotherapy regimens in 54 advanced gastric cancer patients，who were pathological diagnosed in our hospital from January 2012 to January 2015.28 cases in TS group treated with tegafur gimeracil oteracil potassium capsule and docetaxel，26 cases in OS group treated with tegafur gimeracil oteracil potassium capsule combined with oxaliplatin.The disease remission rate，control disease rate，mPFS and the incidence of Ⅲ and Ⅳ stage adverse effects in the two groups were compared.Result：In TS and OS group，the disease remission rate were 57.14% and 61.54% (P=0.745)，the control rate of disease were 85.71% and 84.62% (P=0.910)，mPFS were 7.8 months and 8.4 months(P=0.531)；the incidence of adverse reactions of Ⅲ stage and Ⅳ stage in the two groups were 14.29% and 19.23%(P=0.626)，there were no significant difference between the two groups(P>0.05).Conclusion：TS and OS regimens are effective and safe fist-line chemotherapy for advanced gastric cancer，adverse reactions can be tolerated，their are no significant differences in efficacy and adverse reactions.They are recommended in clinical practice.
【Key words】 Gastric cancer； Tegafur gimeracil oteracil potassium capsule； Paclitaxel； Oxaliplatin
First-author’s address：Yingtan People’s Hospital，Yingtan 335000，China
doi：10.3969/j.issn.1674-4985.2017.32.012
在世界范圍内，癌症相关死亡率中，胃癌排在第二位[1]。胃癌早期症状不明显，加之患者就诊意识不强，大部分患者确诊时已属于进展期，其中大部分已有转移，失去手术机会，严重影响了胃癌患者的预后。特别是晚期不可手术和复发的患者，5年生存率<5%[2]。晚期胃癌的主要治疗方法仍然是化疗，可以明显延长患者生存时间，改善生活质量[3]。一线化疗可供选择的方案较多，主要的有效药物有铂类：顺铂和奥沙利铂；紫杉类：紫杉醇和多西紫杉醇；氟尿嘧啶类：5-FU、卡培他滨和替吉奥；蒽环类和伊立替康等[4]。单药有效率低，目前临床常用的方案为两药联合方案，三药联合方案较两药联合方案有效率高[5]，但由于不良反应较大，中国人群耐受性差[6]，国内少用，欧洲应用较为广泛[7]。5-FU类药物是晚期胃癌的基础用药[8]，替吉奥是20世纪90年代由日本大鹏药品研发的口服5-FU前体药物，已称为日本胃癌治疗的一线用药[9]。在SPIRITS试验中确立了顺铂联合替吉奥可以作为晚期胃癌的一线化疗方案[10]，中位生存时间为13.0个月，显著优于替吉奥单药的11.0个月。奥沙利铂是第三代铂类药物，不良反应较顺铂小，在胃癌中可替代顺铂[11]。多西他赛也是胃癌中的有效药物，单药的有效率为20%～28%[12]，在日本的一项Ⅱ期临床研究显示多西他赛每周方案联合小剂量替吉奥有效率达到52.3%，中位生存时间16.0个月，超过了以往的晚期胃癌的一线化疗方案[13]。本文回顾分析本院2012年1月-2015年1月，54例经病理确诊的晚期胃癌患者应用多西他赛联合替吉奥与奥沙利铂联合替吉奥方案的疗效，现报道如下。, 百拇医药(艾碧 陈丽梅 方科)