表柔比星联合奥沙利铂与卡培他滨治疗晚期胃癌

目的：评价表柔比星联合奥沙利铂与卡培他滨（EOX方案）一线治疗晚期胃癌的疗效和安全性。方法：45例晚期胃癌患者接受EOX方案化疗：表柔比星50mg/m2,静脉推注,第1天;奥沙利铂100mg/m2,静脉滴注,第1天;卡培他滨625mg/m2,口服,每天2次,第1~14天。每21天为1周期。每3周期进行1次疗效评价。治疗持续至6周期或疾病进展或出现无法耐受的不良反应。结果：45例患者接受EOX方案化疗共224周期,中位化疗周期为6周期（3~6周期）。总有效率（CR＋PR）为44.4%,疾病控制率（CR＋PR＋SD）为73.3%。其中完全缓解2例,部分缓解18例,稳定13例,进展12例。中位随访期为12个月（5~17个月）,中位疾病无进展生存期（PFS）为6个月（5~7个月）,中位总生存期为10.2个月（8.1~11.9个月）,1年生存率为42.2%。常见的不良反应包括骨髓抑制和胃肠道反应。3度和4度白细胞减少发生率为20.0%,3度和4度中性粒细胞减少发生率为22.2%,3度和4度血小板减少发生率为11.1%。3度恶心、呕吐发生率为13.3%,3度腹泻发生率为2.2%。3度周围神经病变发生率为2.2%。无治疗相关死亡。结论：表柔比星联合奥沙利铂、卡培他滨一线治疗晚期胃癌疗效较好,不良反应可以耐受。

Efficacy and Safety of Epirubicin, Oxaliplatin and Capecitabine as the First-Line Treatment for Patients with Metastatic Gastric Cancer

Objective：To evaluate the efficacy and safety of epirubicin,oxaliplatin and capecitabine（EOX） as the first-line treatment for patients with metastatic gastric cancer.Methods：From Jan.2007 to Aug.2008,45 patients with metastatic gastric cancer were treated with epirubicin 50 mg/m2 on day 1,oxaliplatin 100 mg/m2 on day 1,and capecitabine 625 mg/m2 bid on days 1 to 14.Each cycle was repeated every 21 days.The efficacy was evaluated every 3 cycles.The treatment was not continued until six cycles of chemotherapy or occurrence of disease progress and untolerable toxicities.Results： For 45 patients in this cohort,the overall response rate（ORR） was 44.4%,with the disease control rate（DCR） of 73.3%.The median progression-free survival（PFS） was 6 months（95% CI： 5-7 months） and the median overall survival was 10.2 months（95% CI： 8.1-11.9 months）.The survival rate at 1 year was 42.2%.The common toxicities were myelosuppression and gastrointestinal reaction.The rate of Ⅲ/Ⅳ degree leukopenia,neutropenia,and thrombocytopenia was 20.0%,22.2%,and 11.1%,respectively.Other grade 3 toxicities included nausea/vomiting in five patients（13.3%）,diarrhea in one patient（2.2%） and peripheral sensory neuropathy in one patient（2.2%）.No treatment related death was observed.Conclusions：The combination of epirubicin,oxaliplatin and capecitabine is feasible and tolerable in the first-line treatment for patients with metastatic gastric cancer.