SOX方案对比FOLFOX4方案治疗进展期胃癌的临床观察

目的 比较替吉奥胶囊（S-1）联合奥沙利铂方案（SOx方案）与奥沙利铂联合氟尿嘧啶、亚叶酸钙方案（FOLFOX4方案）治疗晚期胃癌的疗效与患者不良反应.方法 经病理学确诊的晚期胃癌患者32例,采用随机数字表法分为治疗组（SOX方案组）和对照组（FOLFOX4方案组）,每组患者均至少连用2个周期评价疗效.SOX方案组：奥沙利铂130 mg/m2,静脉滴注2h,第1天;S-1每天80 mg/m2,早晚2次餐后口服,连用14d,间隔7d,3周重复,21d为1个疗程.FOLFOX4方案组：奥沙利铂85 mg/m2,静脉滴注2h,第1天,亚叶酸钙200 mg/m2,静脉滴注2h,第1、2天,氟尿嘧啶400 mg/m2,静脉注射,然后600 mg/m2,22 h持续静脉滴注,第1、2天,2周重复,14d为1个疗程.结果 治疗组有效率（RR）为56.25 ％（9/16）,疾病控制率（DCR）为81.25％（13/16）,疾病进展时间（TTP）为7.2个月,中位生存时间（MST）为9.4个月.对照组RR为43.57％（7/16）,DCR为75.00％（12/ 16）,TTP为5.6个月,MST为7.9个月.两组治疗后RR、DCR、TFP及MST组间差异无统计学意义.两组患者主要不良反应为骨髓抑制、消化道反应及外周神经毒性.Ⅲ级以上不良反应主要为白细胞降低,其中治疗组发生率12.50％（2/16）,与对照组的31.25％（5/16）相比,差异无统计学意义（P=0.394）.结论 SOX方案与FOLFOX4方案均为治疗晚期胃癌的有效方案,但SOX方案组MST和OS均有延长趋势,Ⅲ度以上白细胞下降少见,患者耐受性更好.

Comparison between the effect of SOX regimen and FOLFOX4 regimen for advanced gastric cancer

Objective To compare the efficacy and toxicity of SOX and FOLFOX4 regimen in the treatment of advanced gastric cancer. Methods Total of 32 patients with advanced gastric cancer proved pathologically were randomly divided into 2 groups： 16 patients received SOX regimen oxaliplatin 130 mg/m2 as a 2-hour infusion on day 1, S-I capsules 80 mg/（mZ＇d） twice a day per oral from day 1 to day 14 every 3 weeks], the other 16 patients received FOLFOX4 regimen oxaliplatin 85 mg/m2 as a 2-hour infusion on day 1 and a 2-hour infusion of LV 200/（m2.d） followed by a 5-Fu bolus 400/（m2.d） and 22-hour infusion 600/（m2＂d） for 2 consecutive days every 2 weeks]. Efficacy was evaluated at least 2 cycles. Results The response rates of SOX group and FOLFOX4 group were 56,25 % （9/16） and 43.57 % （7/16）, the disease control rates were 81.25 % （13/16） and 75.00 % （12/16）. The median progress free survival times were 7.2 months and 5.6 months, the median overall survival times were 9.4 months and 7.9 months. The main toxicity in the two groups was hematological toxicity, nausea/vomiting, and peripheral neuropathy. The main grade 3 hematologic toxicity was ncutropenia, with no significant difference between them 12.50 % （2/16） vs 31.25 % （5/16）, P = 0.394]. Conclusions Both SOX and FOLFOX4 regimens are effective for patients with advanced gastric cancer. Compared with FOLFOX4 regimen, SOX regimen is better tolerated for advanced gastric cancer with longer progress free survival and overall survival.