奥沙利铂联合希罗达或替加氟方案治疗老年晚期胃癌的临床观察

目的比较老年晚期胃癌应用奥沙利铂联合希罗达或替加氟方案化疗的疗效和安全性。方法 72例老年晚期胃癌按收治的时间顺序交替分为两组,A组用奥沙利铂联合希罗达方案化疗,B组用奥沙利铂联合替加氟加亚叶酸钙方案化疗,两组均化疗3个周期,比较两组的疗效和毒副反应。结果 A组化疗有效率36.1%,B组有效率38.9%,两组间疗效差异无统计学意义;两组初治均比复治有效率略高,但差异无统计学意义。毒副反应主要为血液学毒性、胃肠道反应和外周神经毒性、手足综合征。两组的白细胞减少及外周神经毒性无统计学差异。A组共发生血小板减少共12例,发生率33.3%,其中有2例Ⅲ度血小板减少;B组发生血小板减少共6例,发生率16.7%,未发生Ⅲ、Ⅳ度血小板减少。A组血小板减少发生率明显高于B组,两组有显著统计学差异(P<0.005)。B组胃肠道反应发生率为77.8%,且有2例Ⅲ度胃肠道反应,明显高于A组的61.1%,两者差异有统计学意义(P<0.05)。A组共发生手足综合征12例,其中2例为Ⅲ度,发生率为33.3%;B组共发生手足综合征5例,均为Ⅰ度,发生率为13.9%,两组手足综合征的发生率差异有统计学意义(P<0.05)。结论老年晚期胃癌应用奥沙利铂联合希罗达或替加氟方案化疗均取得较好的疗效,耐受性可。希罗达组的血液学毒性及手足综合征发生率较高,卡莫氟组胃肠道反应高于对照组。

A comparison of oxaliplatin combined with xeloda or tegafur regimen for treating older patients with advanced gastric cancer

Objective To compare the efficacy and toxicity of oxaliplatin combined with xeloda regimen versus oxaliplatin,tegafur and leucovorin regimen for treating advanced older gastric cancer. Methods Total 72 patients older than 60 years with advanced gastric cancer were divided into 2 groups according to the admission date.Patients in group A received oxaliplatin combined with xeloda regimen;Leucovorin,tegafur and oxaliplatin regimen were applied in group B.Efficacy and toxicity were evaluated after 3 cycles. Results In group A,overall response(CR+PR) rate was 36.1%,meanwhile 38.9% in group B.No significant difference was found between two groups in overall response rate.The most common toxicities were reversible bone marrow suppression,nausea and vomiting,periphery neurotoxicity and hand-foot syndrome.The rate of white blood cells deceasing and periphery neurotoxicity were similar in groups A and B(P>0.05).The rate of platelet deceasing was 33.3% in group A,with 2 patients who had Ⅲ degree,while it was 16.7% in group B.There was significantly different between two groups(P<0.005).The rate of adverse digestive reaction was higher in group B than that in group A(77.8% vs 61.1%,P<0.05).The rate of hand-foot syndrome in group A was higher than that in group B(33.3% vs 13.9%)with 2 patients who had Ⅲ degree hand-foot syndrome. Conclusion Oxaliplatin combined with xeloda regimen and leucovorin,tegafur,oxaliplatin regimen are both effective in patients older than 60 years with advanced gastric cancer.But the rate of platelet deceasing and hand-foot syndrome in oxaliplatin combined with xeloda regimen was higher;while leucovorin,tegafur,oxaliplatin regimen had more adverse digestive reaction.