摘要
目的:观察对比卡培他滨和替吉奥在晚期胃癌一线诱导化疗后维持治疗的疗效和不良反应。方法:收集2010年1月至2016年1月北京大学深圳医院诊治的130例晚期胃癌患者,经XELOX或SOX方案诱导治疗4~6个周期,或m FOLFOX6方案诱导治疗6~8个周期,疗效评价无疾病进展(progressive disease,PD)的患者,分为卡培他滨维持治疗组(1 000 mg/m^2,2次/d,口服,d1~14,21 d为1个周期);替吉奥维持治疗组:1)体表面积≤1.25 m^2,40 mg/次;2)体表面积1.25~1.5 m^2,50 mg/次;3)体表面积≥1.5 m^2,60 mg/次,2次/d,早晚口服,d1~14,21 d为1个周期,或观察组维持化疗持续到PD或出现不能耐受不良反应为止。结果:130例患者中采用XELOX、SOX和m FOLFOX6方案治疗的例数分别为44、33和53例,总体疾病控制率(disease control rate,DCR)为63.1%。82例患者中采用卡培他滨、替吉奥维持治疗和观察的例数分别为35、28和19例。卡培他滨组与替吉奥维持治疗组的疗效无显著性差异(P=0.678)。卡培他滨组、替吉奥组的疾病进展时间(time to progress,TTP)分别为8.5个月和9.0个月(P>0.05),均优于观察组的6.0个月(P<0.001)。卡培他滨组、替吉奥组和观察组的总生存期(overall survival,OS)无显著性差异(14.5 vs.15.0 vs.14.0,P=0.188)。维持化疗患者不良反应主要以骨髓抑制、胃肠道反应、疲乏、手足综合征和口腔炎等为主,无治疗相关死亡。结论:卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗疗效相当,均可延长患者TTP,不良反应较轻。
Objective：To evaluate the efficacy and adverse reaction caused by Capecitabine compared with S-1 as maintenance treat-ments for patients with advanced gastric cancer （AGC） after first-line induction chemotherapy. Methods：A total of 130 AGC patients who did not suffer disease progression after first-line chemotherapies, including XELOX （four to six cycles）, SOX （four to six cycles）, and mFOLFOX6 regimen （six to eight cycles）, were randomized into three groups. The Capecitabine group （Cap） received maintenance che-motherapy with Capecitabine （1 000 mg/m2 twice daily for 14 days, 21 days/cycle）, while the S-1 group （S1） received S-1 （40, 50, or 60 mg according to the body surface area and orally administered twice a day for 14 days, 21 days/cycle）. The control group was consid-ered as the observation group. Patients with maintenance treatments received drugs until disease progression or observation of intol-erant toxicity. Results：A total of 44, 33, and 53 patients received XELOX, SOX, and mFOLFOX6 regimens, respectively. The overall DCR was 63.1%. Among the 82 patients, 35, 28, and 19 belonged to the Cap, S1, and observation groups, respectively. The comparison be-tween the efficacy of treatments in the Cap and S1 groups did not show statistically significant differences （P=0.678）. The median time of progression was 8.5 months in the Cap group and 9.0 months in the S1 group （P〉0.05）. Both groups showed better responses than the observation group, which demonstrated a median progression of 6.0 months （P〈0.001）. The median overall survivals were 14.5, 15.0, and 14.0 months in the Cap, S-1, and observation groups, respectively （P=0.188）. The most common adverse effects observed among the patients with maintenance treatments included myelo-suppression, gastrointestinal reaction, fatigue, hand-foot syndrome, and stomatitis. No death occurred in relation to the therapy. Conclusion：The effectiveness of Capecitabine and S-1 as maintenance chemotherapies in AGC pat
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2016年第20期913-917,共5页
Chinese Journal of Clinical Oncology
关键词
胃癌
卡培他滨
替吉奥
维持化疗
疗效
不良反应
S-1
gastric cancer
Capecitabine
maintenance chemotherapy
therapeutic efficacy
adverse effects
