【摘要】 目的观察与比较伊立替康或奥沙利铂联合氟尿嘧啶类药物一线治疗晚期胃癌的疗效和安全性。方法 71例初治晚期胃癌患者,分别使用伊立替康(37例)180 mg/m2d1或奥沙利铂(34例)85 mg/m2d1联合氟尿嘧啶类药物:5-氟尿嘧啶(5-Fu)400 mg/m2静推d1,2+5-Fu 600 mg/m2持续静滴22 h d1,2+亚叶酸钙200 mg/m2d1,2,14 d为1周期或口服卡培他滨1.0 g/m21日2次,d1~14,21 d为1疗程或口服替吉奥25 mg/m21日2次,d1~14,21 d为1疗程。结果 65例患者可评价疗效。伊立替康组和奥沙利铂组的有效率分别为32.35%和22.58%,疾病控制率分别为76.47%和70.97%,中位无进展生存时间分别为5个月(3.962~6.038个月)和4个月(2.730~5.270个月),两组间差异均无统计学意义(P>0.05)。两组患者不良反应易耐受,主要为粒细胞减少和恶心、呕吐。伊立替康组腹泻发生率较高,为45.95%。奥沙利铂组外周神经损伤的发生率为29.41%。结论伊立替康或奥沙利铂联合氟尿嘧啶类药物一线治疗晚期胃癌的疗效相当,不良反应可以耐受。更多还原

【Abstract】 Objective To retrospectively observe and compare the efficacy and safty of irinotecan or oxaliplatin combined with fluoropyrimidine in the first line treatment of advanced gastric cancer. Methods 71 patients were divided into two groups. The irinotecan group consisted of 37 patients. Irinotecan 180 mg / m2was injected in 90 minutes on d1. And the oxaliplatin group consisted of 34 patients. Oxaliplatin 85 mg / m2was injected on d1. All the groups combined fluoropyrimidine. 5-Fluorouracil(5-Fu) 400 mg / m2and leucovorin 200 mg / m2were injected on d1,2 and 5-Fu 600 mg / m2was 22 h continuous injected on d1,2,every 2 weeks was a cycle. It could also take capecitabine 1. 0 g / m2or tegafur-gimeracil-oteracil potassium 25 mg / m2Bid for d1 ~ 14 orally,every 3 weeks was a treatment. Results 65 patients were evaluated. The response rates were 32. 35% and 22. 58%,the disease control rates were 76. 47% and 70. 97%,and the median progression free survival(PFS) were 5(3. 962 ~ 6. 038) months and 4(2. 730 ~ 5. 270) months in irinotecan group and oxaliplatingroup,respectively,with no significant difference(P > 0. 05). Toxicity was tolerable,major adverse events were neutropenia,nausea and vomiting in two group. The incidence rate of diarrhea(45. 95%) was higher in irinotecan group,and the peripheral nerve toxicity was 29. 41% in oxaliplatin group. Conclusion The effects of irinotecan or oxaliplatin combined with fluoropyrimidine in the treatment of advanced gastric cancer are comparable,and their toxicities are tolerable.更多还原