奥沙利铂联合紫杉醇脂质体治疗晚期胃癌的疗效分析

摘要

目的 探讨奥沙利铂联合紫杉醇脂质体或替吉奥治疗晚期胃癌的临床疗效及不良反应.方法 选取46例晚期胃癌患者作为研究对象.按照随机数字表法将46例晚期胃癌患者随机分为A组和B组,每组23例.其中,A组患者接受奥沙利铂联合紫杉醇脂质体方案化疗,B组患者接受奥沙利铂联合替吉奥方案化疗.比较两组患者的客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS)和不良反应发生情况.结果 A组患者的ORR为47.8%,DCR为78.3%;B组患者的ORR为43.5%,DCR为69.6%;两组患者的ORR和DCR比较,差异均无统计学意义(P=0.767、0.502).A组和B组患者的中位OS分别为9.4个月和9.5个月,两组比较,差异无统计学意义(P=0.911).A组患者的中位PFS为6.9个月(95%CI:6.2~7.8个月),长于B组患者的5.4个月(95%CI:4.0~5.9个月),差异有统计学意义(P=0.048).两组患者的中性粒细胞减少、血小板减少、贫血、疲劳乏力、腹泻、关节肌肉疼痛、恶心呕吐以及神经毒性的发生率比较,差异均无统计学意义(P﹥0.05).结论 奥沙利铂联合紫杉醇脂质体方案和奥沙利铂联合替吉奥方案治疗晚期胃癌的临床疗效接近,但在晚期胃癌患者的无进展生存期方面,奥沙利铂联合紫杉醇脂质体方案可能优于奥沙利铂联合替吉奥方案.%Objective To observe the clinical efficacy and adverse reactions of chemotherapy of oxaliplatin com-bined with either paclitaxel liposome or S-1 for advanced gastric cancer.Method 46 patients with advanced gastric carci-noma were enrolled and randomized as group A and B,with 23 cases in each.Patients in group A accepted oxaliplatin combined with paclitaxel liposome;and in group B,oxaliplatin and S-1 were administered.The objective response rate (ORR),disease control rate (DCR),progression-free survival (PFS),overall survival (OS) and adverse reactions were ob-served and compared between the two groups.Result The ORR in group A was 47.8%,DCR was 78.3%,while in group B,the ORR was 43.5%,DCR was 69.6%,there were no significant differences observed for the ORR and DCR between the two groups (P=0.767,0.502).The median OS of group A and group B were 9.4 months and 9.5 months,showing no significant difference (P=0.911).The median PFS in group A was 6.9 months (95%CI: 6.2-7.8 months),which was longer than that in group B at 5.4 months (95%CI: 4.0-5.9 months),with statistically significant difference observed (P=0.048).There were no significant difference regarding the incidence of neutropenia,thrombocytopenia,anemia,fatigue,asthenia,diarrhea,joint and muscle pain,nausea and vomiting,as well as neurotoxicity,with no statistically significant differences observed (P>0.05).Conclusion These two chemotherapy regimens,oxaliplatin plus paclitaxel liposome or S-1 have sim-ilar clinical effect for advanced gastric cancer,while oxaliplatin combined with paclitaxel liposome may be better than ox-aliplatin plus S-1 in regard of PFS.