替吉奥联合伊立替康治疗晚期胃癌的临床观察

目的 化疗是晚期胃癌的主要治疗手段,晚期胃癌的化疗至今国际上没有公认的标准化疗方案。本研究旨在探讨替吉奥联合伊立替康治疗晚期胃癌的临床疗效和不良反应。 方法 收集2013年5月—2016年5月安徽医科大学第一附属医院肿瘤内科收治的24例符合入组条件的晚期胃癌患者,给予伊立替康静脉滴注联合口服替吉奥方案化疗,每个患者至少完成2个周期化疗,预计46个周期的治疗,2个周期评价疗效,对疗效及不良反应进行观察。临床疗效采用新的实体瘤疗效评价标准(RECIST)进行评价,毒副反应按照WHO抗癌药物毒性反映分度标准评定分级。应用SPSS 13.0统计软件进行统计分析,药物疗效分析应用χ2检验。 结果 24例均可评价疗效,其中完全缓解1例,部分缓解7例,病变稳定7例。有效率为33.3%,疾病控制率62.5%。常见的不良反应有恶心、呕吐、乏力、骨髓抑制、转氨酶升高、迟发性腹泻等。不良反应多为Ⅰ/Ⅱ度,Ⅲ/Ⅳ度不良反应主要是白细胞减少(12.5%)、中性粒细胞减少(16.7%)、血小板减少(4.2%)、血红蛋白降低(4.2%)和迟发性腹泻(8.3%)。 结论 替吉奥联合伊立替康治疗晚期胃癌可有效提高近期有效率及疾病控制率,不良反应可耐受,给药方式亦比较方便,值得临床进一步应用。 

Clinical effect of irinotecan combined tegafur-gimeracil-oteracil potassium capsule on advanced gastric cancer

Objective Chemotherapy is the main treatment for advanced gastric cancer, and there is no universally accepted standard chemo-therapy for advanced gastric cancer. The purpose of this study is to observe the effects and adverse reactions of irinotecan combined with tegafur-gimeracil-oteracil potassium capsule (S-1) in the treatment of advanced gastric cancer. Methods Total 24 patients with advanced gastric cancer who meet the entry criteria in the First Affiliated of Anhui Medical University from May, 2013 to May, 2016 were enrolled into this study. The chemotherapy regiment was Irinotecan intravenous drip combined with oral S-1; two or more cycles of chemotherapy were conducted. All patients were expected to four to six cycles of treatment and the effect of chemotherapy was evaluated every two cycles. The efficacy and adverse effects were evaluated. The efficacy of therapy was evaluated according to RECIST, and toxicity effects. SPSS 13. 0software was used for statistical analysis. The analysis of therapy was conducted by using the χ2 testing. Results All 24 patients were evaluable, 1 patient reached complete response, 7 patients with partial response, 7 patients with stable disease. The overall response rate was 33. 3%, and the disease control rate was 62. 4%. The major adverse effects were nausea and vomiting, myelosuppression and delayed diarrhea. Most adverse reactions were type Ⅰ/Ⅱ, as type Ⅲ/Ⅳ ere reduction of white blood cells (12. 5%), neutrophil (16. 7%), platelet hemoglobin and Late-onset diarrhea. Conclusion Irinotecan combined with S-1 shows good efficacy and disease control rate in treatment of advanced gastric cancer. Adverse reactions of this treatment are tolerable, and the way of drug delivery is more convenient. It is worthy of further application.