摘要
目的探讨人类表皮生长因子受体2(human epidermal growth factor receptor-2,Her-2)阴性晚期胃癌一线化疗后替吉奥联合沙利度胺维持治疗的疗效与安全性。方法收集2014年1月—2017年12月在池州市人民医院诊治的Her-2阴性复发转移晚期胃癌经SOX、XELOX或mFOLFOX6方案一线化疗4~6周期,化疗后评估无疾病进展患者40例,随机分为维持组和对照组,维持组(20例),一线化疗后口服替吉奥胶囊及沙利度胺治疗,至病情进展或严重的药物毒副反应;对照组(20例):一线化疗后停用抗肿瘤药物仅予随访观察及对症治疗。分析2组临床疗效及不良反应。结果维持组较对照组的客观有效率提高,差异有统计学意义(35.0%vs 0,P<0.05);疾病控制率提高(75.0%vs 35.0%,P<0.05)。维持组中位无进展生存时间(mPFS)(8.25个月)长于对照组(5.5个月),差异有统计学意义(P<0.05);2组中位总生存期(mOS)分别为12.8个月与11.7个月,差异无统计学意义(P>0.05)。维持组不良反应以Ⅰ-Ⅱ度白细胞减少、乏力、肝功能损伤为主,对症治疗后均好转,无因不良反应停止治疗及治疗相关死亡病例。结论Her-2阴性晚期胃癌一线化疗达病情控制后行替吉奥联合沙利度胺维持治疗疗效确切,耐受性好,安全性高,增加有效率,延长中位无进展生存期。
Objective To explore the effectiveness and safety of tegafur combined with thalidomide in the maintenance treatment of human epidermal growth factor receptor-2(Her-2)negative patients with advanced gastric cancer.Methods A total of 40 patients with Her-2 negative recurrent and metastatic gastric cancer were enrolled,who were admitted in Chizhou People's Hospital from January 2014 to December 2017 and underwent first-line chemotherapy for 4—6 cycles by SOX,XELOX or mFOLFOX6,with progression-free survival.The patients were randomly divided into two groups(n=20):a maintenance group and a control group.Patients in the maintenance group were orally administered with tegafur combined with thalidomide as the first-line chemotherapy,until progress of the disease or severe adverse reactions.The control group was simply followed up and symptomatically treated after the first-line anti-tumor drugs were discontinued.Both groups were compared for clinical effectiveness and adverse reactions.Results The maintenance group was more objective and effective than the control group(35.0%vs 0,P<0.05),with an increased disease control rate(75.5%vs 35.0%,P<0.05).The maintenance group showed significantly longer modified progression-free survival(mPFS,8.25 months)than the control group(5.5 months)(P<0.05).The modified overall survival(mOS)of the two groups were 12.8 months and 11.7 months,without statistical difference(P>0.05).The maintenance group was characterized byⅠ-Ⅱdegree leukopenia,fatigue,liver function damage,while the adverse reactions were improved after symptomatic treatment,without toxic side effects and treatment related deaths.Conclusions After first-line chemotherapy of Her-2 negative and advanced gastric cancer,tegafur combined with thalidomide is effective in maintenance treatment,with accurate effectiveness,good tolerance,high safety and extended median PFS.
作者
华高艳
朱益平
程亮
郑中显
潘明
HUA Gaoyan;ZHU Yiping;CHENG Liang;ZHENG Zhongxian;PAN Ming(Department of Oncology,the People's Hospital of Chizhou Affiliated to Wannan Medical College,Chizhou,Anhui 247000,China;Department of Oncology,the First Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241000)
出处
《徐州医科大学学报》
CAS
2021年第10期724-728,共5页
Journal of Xuzhou Medical University
基金
安徽省高校自然科学研究重点项目(KJ2017A262)。
关键词
替吉奥
沙利度胺
HER-2
晚期胃癌
维持治疗
tegafur
thalidomide
Her-2
advanced gastric cancer
maintenance treatment
