摘要
目的:评价卡培他滨联合奥沙利铂方案(XELOX)与氟尿嘧啶/亚叶酸钙联合奥沙利铂方案(FOL-FOX4)治疗进展期胃癌的临床疗效及不良反应。方法:54例进展期胃癌患者随机分成两组,XELOX组28例,卡培他滨1000mg/m2,口服,2次/日,第1-14天;奥沙利铂135mg/m2,静脉点滴,第1天,21天为1个周期。FOLFOX4组26例,奥沙利铂85mg/m2,静脉点滴,第1天;亚叶酸钙200mg/m2,静滴2h后予氟尿嘧啶400mg/m2,推注,后续600mg/m2持续静滴2h,第1、2天,每2周重复,4周为1周期。两组均治疗4周期以上。结果:XELOX组有效率53.57%,中位TTP5.8个月,MST10个月,FOLFOX4组有效率46.15%,中位TTP5.7个月,MST9.8个月。两组近期有效率差异无显著性。不良反应比较,手足综合征以XELOX组显著(P<0.05),III/IV级恶心呕吐发生率以FOLFOX4组显著(P<0.05),其余不良反应除腹泻外发生率以FOLFOX4组稍高,但差异无显著性。结论:XELOX方案与FOLFOX4方案治疗进展期胃癌疗效确切,不良反应能耐受,两组近期疗效相似,不良反应以XELOX组更易耐受,尤其对一般情况欠佳及老年的患者耐受性好。
Objective： To evaluate the efficacy and toxicity of combination regimen of capecitabine plus oxaliplatin regimen （ XELOX ） versus fluorouracil/leucovorin plus oxaliplatin regimen （FOLFOX4） in the treatment of advanced gastric cancer. Methods： Total of 54 cases with advanced gastric cancer were enrolled into this study ,28 patients and 26 patients were randomly divided into XELOX group and FOLFOX4 group respectively. XELOX group was treated with capecitabine 1000mg/（ m2 ~ d）, po, bid, d~ _ 1,, oxaliplatin 130mg/（ m2 ~ d）,ivgtt, dl ; FOLFOX4 group was trea- ted with oxaliplatin 85rag/（ m2 ~ d） ,ivgtt,dI ,LV20Omg/m2 ,ivgtt 2 hour followed by 5 -FU 400rag/m2 （bolus） and 5 -FU 600mg/m2 （22hr -coutinous infusion）. XELOX regimen was repeated every 3 weeks for one cycle, FOLFOX4 regimen was repeated every 2 weeks,4 weeks for one cycle. All patients received four cycles of chemotherapy at least. Results： The overall response rate was 53.57% （ CR 1, PR 14） in XELOX group of 28 eases and 46. 15% （CR 1 ,PR 11） in FOLFOX4 group of 26 eases. The difference in response rate was not statistically significant be- tween the two groups（P=0.586 ）. The median time to progression （mITP） was 5.8 months in XELOX group and 5.7 months in FOLFOX4 group. The median survival time （MST） was 10.0 months in XELOX group and 9.8 months in FOLFOX4 group. The toxieities were well tolerated. The incidence of grade III ＋ IV nausea and vomiting was significantly lower in XELOX group than in FOLFOX4 group（ P 〈 0.05 ） but hand and foot syndrome in XELOX group was more obvious than in FOLFOX4 group （P 〈 0.05 ） ,incidence of other side effects in FOLFOX4 group was higher than that in XELOX group except for diarrhea, but no significance existed （ P 〉 0.05 ）. Condusion： Both of the two regimens were feasible ,well tolerated and effective in treatment of advanced gastric cancer. XELOX regimen may be safer than FOLFOX4 regimen, especially in elderly patients or patients with ECOG PS o
出处
《现代肿瘤医学》
CAS
2010年第5期947-950,共4页
Journal of Modern Oncology
