替吉奥单药与XELOX方案一线治疗老年晚期胃癌的疗效比较

目的:比较替吉奥单药与XELOX方案一线治疗老年晚期胃癌的疗效及不良反应.方法:将41例老年进展期胃癌患者随机分为单药组和联合化疗组.单药组20例,替吉奥单药口服,每次40~60 mg(体表面积<1.25 m2剂量为每次40 mg;体表面积为1.25~1.5 m2剂量为每次50 mg;体表面积>1.5 m2为每次60 mg),每天2次,连用14 d,每3周重复;联合化疗组21例,XELOX方案化疗,奥沙利铂130 mg/m2,静脉滴注3 h,第1天;卡培他滨1000 mg/m2,每天2次,连服14 d,每3周重复.每用药2个周期后评价疗效.结果:单药组有效率30.0%、疾病控制率65.0%,中位无进展生存时间为5.6个月;联合化疗组有效率42.9%,疾病控制率66.7%,中位无进展生存时间为6.2个月.2组差异均无统计学意义(P>0.05).联合化疗组的周围神经毒性发生率高于单药组(P<0.05),其他化疗不良反应发生率差异均无统计学意义(P>0.05).结论:替吉奥单药治疗老年进展期胃癌可取得不弱于联合化疗方案的近期疗效,且有较低的不良反应.

Comparison of the curative effect of tegafur with XELOX program in the treatment of elderly patients with advanced gastric cancer

Objective:To compare the curative effects and adverse reactions of Tijiao with XELOX program in the treatment of elderly patients with advanced gastric cancer. Methods:Forty-one elderly patients with advanced gastric cancer were randomly divided into the single drug group(20 cases)and combined chemotherapy group(21 cases). The single drug group were treated with the Tijiao by oral, twice a day for 14 days,repeated every 3 weeks(40 mg each time for the body surface area <1. 25 m2 ,50 mg each time for the body surface area between 1. 25 m2 and 1. 5 m2 and 60 mg each time for the body surface area >1. 5 m2 ). The combined chemotherapy group were treated with XELOX program, which included the 130 mg/m2 of oxaliplatin by intravenous dripat first day for 3 hours combined with 1000 mg/m2 of capecitabineby oral,twice a day for 14 days,repeated every 3 weeks. The curative effects in two groups were evaluated after 2 cycles of treatment. Results:The effective rate,disease control rate and median progression-free( PFS) time in single drug group were 30%,65% and 5. 6 months,respectively,the effective rate,disease control rate and median progression-free time in combined chemotherapy group were 42. 9%, 66. 7% and 6. 2 months, respectively, and the difference of which between two groupswas not statistically significant(P>0. 05). The incidence rate of peripheral neurotoxicity in combined chemotherapy group was higher than that in single drug group(P<0. 05),and the incidence of other adverse reactions between two groups was not statistically significant(P>0. 05). Conclusions:The short-term curative effect of the Tijiao in treating advanced gastric cancer elderly patients is not worse than that of combination chemotherapy,and which has less adverse reaction.