目的 评价奥沙利铂联合卡培他滨(XELOX)方案一线治疗进展期胃癌的临床疗效和安全性.方法 对54例首次确诊且可接受化疗的进展期胃癌患者行XELOX方案化疗,奥沙利铂130 mg/m2,静滴,第1天;卡培他滨1 000 mg/m2,口服,2次/d,第1～14天.2个周期后评价化疗效果,无效病例终止化疗;有效病例继续行原方案化疗4～6个周期,按WHO标准评价临床疗效和毒副反应.结果 完全缓解(CR)3例,部分缓解(PR)31例[近期总有效率为63％(34/54)],稳定(SD)13例,进展(PD)5例;临床受益反应(CBR)获益率为80.0％,无化疗相关死亡病例.主要毒副反应有骨髓抑制、呕吐、腹泻、外周末梢神经毒性等,患者均可耐受.结论 XELOX方案一线治疗进展期胃癌可获得较高的近期缓解率及CBR获益率,且毒副反应患者可以耐受;其远期效果值得临床进一步研究.%Objective To evaluate the efficacy and the safety of XELOX in previously untreated patients with advanced gastric cancer (AGC). Methods Total 54 patients received intravenous oxaliplatin at the dose of 130 mg/mz for over 2 h on day 1, plus oral capecitabine 1 000 mg/m twice daily on days 1-14, every 3 weeks (XELOX). Clinical efficacy was evaluated two weeks later, on the basis of which, chemotherapy was stopped in the patients without effectiveness, otherwise, XELOX regimen was continued for 4 to 6 weeks in those with active response to the chemotherapy. Results Of 54 patients, the overall response rate was 63% (34/54) , with a complete response ( CR) in three patients and a partial response (PR) in 31 patients, stable disease (SD) was demonstrated in 13 patients (24%) , 9% of patients (5/54) pro-gressed(PD) ; The positive rate of clinical benefit response (CBR) was 80. 0% , while no patients dead for the XELOX therapy. The main side effects included myelosuppression, vomiting, diarrhoea, and hand-foot syndrome. All the side effects were tolerable. Conclusion XELOX has a more better therapeutic effect and can be well tolerated as a first-line therapy for AGC; The long-tern effects should be studied further.
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