替吉奥或卡培他滨联合顺铂治疗晚期胃癌临床疗效研究

目的比较替吉奥联合顺铂(SP)与卡培他滨联合顺铂(XP)一线治疗体力状况(ECOG)评分0～1分初治晚期胃腺癌的疗效和安全性。方法将37例ECOG评分0～1分初治晚期胃腺癌患者随机分为两组。SP组18例,给予替吉奥80 mg.m-2.d-1;XP组19例,给予卡培他滨2 000 mg.m-2.d-1;均早晚分2次口服,连服14 d,停药7 d。顺铂均为75 mg/m2,第1天静脉滴注。21 d为1个周期。结果 37例患者均可评价疗效,SP组完全缓解(CR)1例,部分缓解(PR)8例,稳定(SD)4例,进展(PD)5例;XP组CR 0例,PR 8例,SD 5例,PD 6例。两组患者疗效间差异无统计学意义(P>0.05)。SP组和XP组患者肿瘤进展时间分别为5.9个月和5.5个月[HR=0.92,95%CI(0.72,1.13),P=0.065],总生存期分别为12.4个月和11.9个月[HR=0.94,95%CI(0.78,1.09),P=0.061]。两组的不良反应主要为骨髓抑制、消化道反应和乏力,SP组Ⅲ～Ⅳ度血小板减少发生率显著低于XP组(5.6%与15.8%,χ2=4.08,P=0.049),Ⅲ～Ⅳ度手足综合征的发生率亦显著低于XP组(0与21.1%,χ2=4.25,P=0.046)。结论 SP与XP治疗ECOG评分0～1分初治晚期胃腺癌患者疗效相当,但SP患者耐受性更好,值得临床进一步研究使用。

Curative Effect Analysis of S-1 Combined with Cisplatin or Capecitabine Combined with Cisplatin in the Treatment of Advanced Gastric Cancer

Objective To compare the safety and efficacy of S-1 combined with cisplatin and capecitabine combined with cisplatin in the initial treatment for patients with advanced gastric cancer whose ECOG is 0～1.Methods Thirty-seven patients with advanced gastric cancer and with ECOG from 0 to 1 were randomly divided into two groups.Patients in SP group(n=18) received S-1 80 mg·m-2·d-1;Patients in XP group(n=19) received capecitabine 2 000 mg·m-2·d-1;oral administration twice a day in both groups for 14 days;Both groups were given cisplatin 75 mg/m2,ivgtt on day one.The course was twenty-one days in two groups.Results All patients were evaluable.SP group:CR 1,PR 8,SD 4,PD 5;XP group:CR 0,PR 8,SD 5,PD 6.The efficacy of the two groups showed no statistically significant difference(P>0.05).TTP were 5.9 months and 5.5 months respectively for each group,OS were 12.4 months and 11.9 months respectively for each group.The main untoward effects were myelosuppression,gastroenteric reaction and weakness.SP group showed a lower rate of untoward effects than XP group.SP group also showed a lower rate of Ⅲ～Ⅳ thrombocytopenia(5.6% vs 15.8%,χ2=4.08,P=0.049) and hand-foot syndrome(0 vs 21.1%,χ2=4.25,P=0.046) than XP group.Conclusion The treatment of the two groups were evidently effective,with SP group having better tolerance.The regimen could be clinically recommended.