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目的评价卡培他滨联合奥沙利铂方案治疗老年性胃癌的疗效及不良反应。方法将2003年1月至2006年12月78例老年性胃癌患者随机分为治疗组(卡培他滨联合奥沙利铂)及对照组(5-Fu联合奥沙利铂及亚叶酸钙),每组39例。治疗组奥沙利铂130 mg/m2静脉滴注2 h,第1天口服希罗达化疗2 000 mg/m2,每天分2次服用,第1～14天,每3周为一个化疗周期。对照组奥沙利铂130 mg/m2静脉滴注2 h,第1天;亚叶酸钙200 mg静脉滴入,第1～5天;5-Fu 250 mg快速静脉滴注,500 mg持续静脉泵10 h,第1～5天,每3周为一个化疗周期。每例患者均接受4个周期化疗。结果治疗组有效率为60.0%,对照组有效率为46.2%(P<0.05)。治疗组2年生存率为38.5%,高于对照组的19.2%(P<0.05),中位生存时间(MST)治疗组为20月,优于对照组的17月(P<0.05)。治疗组患者的骨髓抑制及胃肠道反应低于对照组。结论卡培他滨联合奥沙利铂方案是一种安全、有效的治疗胃癌的方案,尤其适合于老年患者。
Objective To evaluate the efficacy and side effects of capecitabine combined with oxaliplatin in the treatment of senile gastric cancer. Methods A total of 78 elderly patients with gastric cancer from January 2003 to December 2006 were randomly divided into treatment group (capecitabine plus oxaliplatin) and control group (5-Fu combined with oxaliplatin and leucovorin) , 39 cases in each group. The treatment group oxaliplatin 130 mg / m2 intravenous infusion of 2 h, the first day of oral Xeloda chemotherapy 2 000 mg / m2, taken twice daily, the first to 14 days, every 3 weeks for a chemotherapy cycle. The control group oxaliplatin 130 mg / m2 intravenous infusion of 2 h, the first day; leucovorin 200 mg intravenous infusion, the first 5 days; 5-Fu 250 mg rapid intravenous infusion, 500 mg continuous intravenous infusion 10 h, 1 to 5 days, every 3 weeks for a chemotherapy cycle. Each patient received 4 cycles of chemotherapy. Results The effective rate was 60.0% in the treatment group and 46.2% in the control group (P <0.05). The 2-year survival rate was 38.5% in the treatment group, which was 19.2% of the control group (P <0.05). The median survival time (MST) in the treatment group was 20 months, which was better than that in the control group in 17 months (P <0.05). Myelosuppression and gastrointestinal reactions in the treatment group were lower than those in the control group. Conclusion Capecitabine combined with oxaliplatin is a safe and effective treatment for gastric cancer and is especially suitable for elderly patients.