摘要
目的比较多西他赛联合奥沙利铂及卡培他滨（DOX方案）与多西他赛联合奥沙利铂及替吉奥（DOS-1方案）治疗进展期胃癌的有效性和安全性。另外，进一步证实检测肿瘤标记物CAl99在胃癌诊治中的意义。方法54例进展期胃癌患者随机分为两组，A组（DOX方案）29例，具体为：多西他赛Docetaxel35mg／m2静滴第l、8天，Oxaliplatin85mg／m2静滴2h，第1天：CAPE1000mg／m2bid，po，dl—d14，21天为1周期；DOS-1组（DOS-1方案）25例，具体为：Docetaxel35mg／m2静滴第1、8天，Oxaliplatin85mg／m2静滴2h，第1天：s-140mg／m2分早晚2次餐后服用，第1～14天，2l天为1周期。2个周期评价疗效及毒性。治疗前后分别进行血常规、肝肾功能、胸腹部cT扫描及胃镜等检查，观察肿瘤病灶大小及肿瘤标志物的变化，记录临床症状变化和化疗毒副反应，随访两组的无疾病进展生存时间。结果54例均可评价疗效，根据RECIST1．0实体瘤疗效评价标准，分cR、PR、sD和PD，以CR＋PR计算有效率（RR），以CR＋PR＋SD计算疾病控制率（DCR），DOX组和DOS-1组的有效率分别为48．3％和52．0％，疾病控制率分别为75．9％和80．0％，中位无疾病进展时间分别为9．6个月和10．4个月，上述两组比较均无统计学差异（P〉0．05）。两组毒副反应主要包括恶心呕吐、腹泻、末梢神经毒性、手足综合征、口腔黏膜炎、血液学毒性和肝肾功能异常等，以l～2级为主，均可耐受。其中DOX组手足综合症发生率高于DOS-1组（P〈0．05），DOS-1组口腔粘膜炎发生率高于DOX（P〈0．05）。结论DOX方案与DOS-1方案治疗进展期胃癌的近期疗效略好于既往的联合方案研究结果，而且它们的生存优于既往的研究结果，耐受性好。但DOS-1方案的优势值得进一步深入研究。
Objective To evaluate the efficacy and toxicity of two different oral fluoropyrimidines capecitabine or S-1 in combination with oxaliplatin and docetaxel in patients with advanced gastric. In addition, to prove significance of tumor marker CA199 on astric carcinoma. Methods Fifty-four advanced gastric patients were divided into two groups： Group DOX： 29 patients were treated with Docetaxel 35 rag/toLd 1,dS, oxaliplatin 85mg/mL d 1 and ca2Petabine 1 000mg/m2 bid dl-14, Three weeks was a cycle. Group DOS-l： 25 patients were treated with Docetaxel 35 mg/mEdl,d8, oxaliplatin 85 mg/m dl and S-1 40mg/m~ orally twice daily aiter meal dl-dl4. Three weeks was a cycle. Blood routine, function of liver and kidney chest and abdomen-CT or MRI and gastroscopy were examined before and after treatment. The changes of cancer focus size, clinical symptoms, turner marker, toxic and side effects were recorded arid compared after 2 cycles. The progress flee survival were observed. Results All patients were assessable for toxicity and response to treatment. In group DOX and group DOS-l, the remission rate were 48.3 % and 52.0%, the disease control rate were 75.9% and 80.0 %, the median progress free survival were 10.4 months and 9.6 months. There was no significance, between group A and group B （P〉0.05）. Side effects were similar in the two groups, mainly in bone marrow depression, nausea and vomiting, diahrrea, dysfunction of liver and kidney, and hand-foot syndrome. All these side effects were of slage 1~2, and well tolerated. Incidence of hand-foot syndrome DOX group is higher than the DOS-1 Group （P〈0.05）, oral muensitis happen than DOX DOS-1 Group （P〈0.05）. Conclusions DOX programme and recent effect of DOS-1 in treatment of advanced gastric cancer was slightly better than previous joint programmes of research results, research results and they＇re living better than the past, and well tolerated. DOS-1 the advantages of the programme worthy of further study.
出处
《疾病监测与控制》
2015年第9期627-630,共4页
Journal of Diseases Monitor and Control
关键词
胃癌
多西他赛
奥沙利铂
卡培他滨
替吉奥
化疗
Gastric cancer
Docetaxeh Oxaliplatin： Capecitabine： S-1
Chemotherapy
