目的：研究国产替吉奥胶囊(S-1)单药与联合奥沙利铂辅助化疗方案在进展期胃癌患者D2根治手术后的疗效和安全性。方法选择D2根治手术后进展期胃癌患者100例，采用隐匿数字随机法分为两组，每组50例，A组给予S-1单药化疗；B组患者给予S-1联合奥沙利铂化疗，记录化疗期间毒副反应，所有患者随访3~36个月，记录患者1年、2年、3年总生存率、无复发生存率。结果 A组1年、2年、3年生存率分别为100.00%、100.00%、83.67%，无瘤生存率分别为100.00%、81.63%、67.35%，B组三年总生存率分别为100.00%、100.00%、95.83%，无瘤生存率分别为100.00%、91.67%、81.25%，两组1年、2年总生存率与1年无瘤生存率比较，差异均无统计学意义(P>0.05)，但B组3年总生存率，2年、3年无瘤生存率明显高于A组，差异均有统计学意义(P<0.05)。A组3年复发转移率为32.65%，明显低于B组，B组消化道毒副反应、血液学毒性发生率高于A组，差异均有统计学意义(P<0.05)。结论两种辅助化疗方案均可延长进展期胃癌患者术后无瘤生存期和总生存期，联合治疗效果更佳，但也会增加毒副反应发生率，因此在方案的选择上应根据患者的耐受性加以选择。%Objective To study the efficacy and safety of S-1 monotherapy or S-1 and oxaliplatin combina-tion chemotherapy for patients with advanced gastric cancer after D2 radical operation. Methods One hundred pa-tients with advanced gastric cancer after D2 radical operation were selected and randomly divided into two groups, with 50 cases in each group. Group A received S-1 monotherapy, while group B was treated by S-1 combined with ox-aliplatin chemotherapy. The adverse reactions of chemotherapy period were recorded. All patients were followed up for 3~36 months. The 1-year, 2-year and 3-year overall survival rates were recorded, as well as the recurrence free survival rate. Results The 1-year, 2-year and 3-year overall survival rates were 100.00%, 100.00%, 83.67% in group A and 100.00%, 100.00%, 95.83%in group B, respectively. Tumor-free survival rates were 100.00%, 81.63%, 67.35%in group A and 100.00%, 91.67%, 81.25%in group B. The two groups showed no statistically significant dif-ference in 1-and 2-year overall survival rates, 1-year tumor-free survival rate (P>0.05), but the 3-year overall sur-vival rate, 2-and 3-year tumor-free survival rate in group B were significantly higher than those in group A (P<0.05). The 3-year recurrence/transfer rate was 32.65%in group A, significantly lower than that of group B. The inci-dence of gastrointestinal toxicity, hematologic toxicity in group B were significantly higher than those in group A (P<0.05). Conclusion The two therapies can both prolong the tumor-free survival and overall survival for patients with advanced gastric cancer after D2 radical operation. The combined treatment has better efficacy but results in higher ad-verse reactions rate. Therefore, the therapies should be selected based on the tolerance of patients.
展开▼
