沙利度胺联合化疗治疗晚期胃癌的临床观察

目的：观察沙利度胺（Thalidomide，反应停）联合奥沙利铂（L—OHP）、亚叶酸钙（CF）和氟尿嘧啶（5-FU）方案治疗晚期胃癌的临床疗效和患者的耐受性，并与单用后3种药物化疗进行比较。方法：采用随机分组的方法将45例晚期胃癌患者分为Thalidomide＋L—OHP＋CF＋5-FU方案组（联合用药组）24例与L—OHP＋CF＋5-FU方案组（化疗组）21例，观察两组的临床疗效和患者的耐受性。结果：联合用药组有效率54．2％（13／24），化疗组有效率42．9％（9／21），联合用药组有效率高于化疗组，但两组差异无统计学意义（P〉0．05）。联合用药组的疾病控制率为83．3％（20／24），化疗组为52．4％（11／21），两组差异有统计学意义（P〈0．05）。联合用药组KPS评分的改善率为75％，化疗组KPS评分的改善率为42．9％，两组差异有统计学意义（P〈0．05）。联合用药组的中位生存期及1年生存率均优于化疗组，但生存期比较差异无统计学意义（P〉0．05）。联合用药组的恶心呕吐发生率较化疗组低，差异有统计学意义（P〈0．05），但联合用药组的便秘的发生率较化疗组高，差异有统计学意义（P〈0．05）；其余毒副反应均相似。结论：与单用化疗相比，沙利度胺联合化疗方案能增加晚期胃癌患者的疾病控制率，同时改善患者的生活质量，具有较轻的消化道反应，疗效是否更优有待于进一步扩大样本量进行临床随机对照研究。

Treatment of advanced gastric cancer with the regimen of thalidomide, oxaliplatin, leucovorin and fluorouracil

Objective：This study was designed to investigate the clinical curative effects and tolerance of patients with advanced gastric cancer of treatment with the regimen of thalidomide, oxaliplatin （ L-OHP）, leucovorin （CF） and fluorouracil （5-FU）. We compared this treatment with the regimen of oxaliplatin, leucovorin and fluorouracil. Methods：In a randomized manner,45 patients with advanced gastric cancer were divided into combined treatment group（thalidomide ＋ L-OHP ＋ CF ＋ 5-FU） and chemotherapy group （ L-OHP ＋ CF ＋ 5-FU）. We compared the clinical curative effects and tolerance between two groups. Results ： The overall responses rate for the combined treatment group and chemotherapy group were 54.2% （13/24） and 42.9% （9/21）, respectively. The overall responses to the combined treatment group were higher than that of the chemotherapy group, but there were no statistically significant difference between two groups （ P 〉 0. 05 ）. The clinically profitted rate from the combined treatment group and chemotherapy group were 83.3% （ 20/24 ） and 52. 4% （ 11/21 ）, respectively. There were statistically significant difference between two groups （ P 〈 0. 05 ）. The improvement rate of KPS score for the combined treatment group and chemotherapy group were 75% （18/24） and 42.9% （9/21）, respectively. Obviously, the improvement of life quality to the combined treatment group were higher than that of the chemotherapy group （P 〈0. 05）. The median survival and 1-year survival rate seen in the combined treatment group were better than that in the chemotherapy group, but there were no statistically significant difference between two groups （P 〉 0. 05 ）. Nausea and vomiting were more pronounced in the chemotherapy group （ P 〈 0. 05 ） ; Constipation was more pronounced in the combined treatment group （ P 〈 0.05 ） ; Other toxcities were similar. Conclusion ： Compared with chemotherapy regimen, thalidomide combined with chemotherapy reg imen obvi