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目的:观察沙利度胺(Thalidomide)联合草酸铂(L-OHP)、亚叶酸钙(CF)、氟脲嘧啶(5-FU)和羟基喜树碱(HCPT)持续给药治疗晚期胃癌的近期疗效及其对生活质量的影响。方法:采用随机分组的方法将41例晚期胃癌患者分为联合用药组(22例),与化疗组(19例)。联合用药组:沙利度胺,起始剂量第1周100 mg/d,晚睡前顿服,如能耐受毒副反应,每周增加100 mg,直至目标剂量300 mg/d维持,如不能耐受加量者,则维持原剂量,至少口服>2个月;L-OHP 85 mg/m2,静脉滴入2 h,d1;CF200 mg/m2,静脉滴入2 h,d1～d2;5-FU400 mg/m2,静脉推注,d1～d2,5-FU600 mg/m2,持续静脉滴入22 h,d1～d2;HCPT 5 mg,持续静脉滴入24 h,d1～d5。化疗组:不加入沙利度胺,其他用法同联合用药组。结果:联合用药组有效率50.0%(11/22),化疗组有效率42.1%(8/19),联合用药组有效率高于化疗组,但两组差异无统计学意义,P>0.05。联合用药组的临床受益率为77.3%(17/22),化疗组为52.6%(10/19),两组差异有统计学意义,P<0.05。联合用药组KPS评分的改善率为68.2%(15/22),化疗组的改善率为36.8%(7/19),两组差异有统计学意义,P<0.05。联合用药组的恶心呕吐发生率较化疗组低,两组差异有统计学意义,P<0.05。其余毒副反应均相似。结论:与单用化疗相比,沙利度胺联合化疗能提高晚期胃癌患者的临床受益率,同时改善患者的生活质量。
Objective: To observe the effects of Thalidomide combined with L-OHP, CF, F-5 and HCPT for the treatment of advanced gastric cancer Efficacy and its impact on quality of life. Methods: Forty-one patients with advanced gastric cancer were divided into the combined treatment group (n = 22) and the chemotherapy group (n = 19) by randomization. Combination therapy group: thalidomide, the initial dose of 100 mg / d in the first week, night sleep before meals, if tolerated toxic side effects, weekly increase of 100 mg, until the target dose of 300 mg / d to maintain, such as Can not tolerate dosage, then maintain the original dose, at least orally> 2 months; L-OHP 85 mg / m2, intravenous infusion 2 h, d1; CF200 mg / m2, intravenous infusion of 2 h, d1 ~ d2; 5-FU 400 mg / m2, intravenous injection, d1 ~ d2,5-FU600 mg / m2, continuous intravenous infusion of 22 h, d1 ~ d2; HCPT 5 mg, continuous intravenous infusion of 24 h, d1 ~ d5. Chemotherapy group: do not join thalidomide, other usage and combination group. Results: The effective rate was 50.0% (11/22) in the combination group and 42.1% (8/19) in the chemotherapy group. The combined group was more effective than the chemotherapy group, but the difference was not significant (P> 0.05). The clinical benefit rate was 77.3% (17/22) in the combination group and 52.6% (10/19) in the chemotherapy group, with a significant difference between the two groups (P <0.05). The improvement rate of KPS score was 68.2% (15/22) in the combination group and 36.8% (7/19) in the chemotherapy group, with a significant difference between the two groups (P <0.05). The incidence of nausea and vomiting in combination group was lower than that in chemotherapy group, the difference was statistically significant (P <0.05). The remaining side effects were similar. Conclusions: Thalidomide combined with chemotherapy increases the clinical benefit rate of patients with advanced gastric cancer and improves the quality of life of patients compared with chemotherapy alone.