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目的:观察de Gramont、和XELOX两组化疗方案治疗晚期胃癌的临床疗效及不良反应,为临床正确选用化疗提供依据。方法:对接受de Gramont、和XELOX二种不同辅助化疗方案的63例晚期胃癌患者,分析二种化疗方案在疗效、总有效率、中位疾病进展时间(TTP)、中位生存期(0S)、主要不良反应之间的差别。结果:两组63例均可评价疗效,de Gramont组30例、XELOX组33例,每例进行2~4个周期的治疗,共完成160个周期。其中deGramont组、XELOX组获得CR(0、0)例,PR(9例30%;15例45.4%P=0.023),SD(6例20%;12例36.4%P=0.036),PD(15例50%;6例18.2%P=0.015),总有效率(RR()30%;45.5%P=0.025)。中位疾病进展时间(TTP)为(3.6个月;5.4个月P=0.038),中位生存期(0s)为(7.4个月;8.9个月P=0.024)。主要不良反应为恶心、呕吐、骨髓抑制二组间无显著性差异,手足综合征和外周神经损害发生率XELOX组明显高于de Gramont组(P=0.013),其他不良反应可耐受,经积极对症治疗后好转。结论:奥沙利铂联合卡培他滨治疗晚期胃癌有较好的疗效,毒副反应可以耐受,值得深入研究。
OBJECTIVE: To observe the clinical efficacy and adverse reactions of de Gramont and XELOX chemotherapy regimens in the treatment of advanced gastric cancer, and to provide a basis for proper clinical selection of chemotherapy. Methods: Sixty-three patients with advanced gastric cancer receiving de Gramont and XELOX different adjuvant chemotherapy regimens were analyzed in terms of efficacy, total effective rate, median time to progression (TTP), median survival (0S) , The main difference between adverse reactions. Results: The curative effect was evaluated in 63 cases in both groups. There were 30 cases in de Gramont group and 33 cases in XELOX group. The treatment was performed in 2 to 4 cycles in each case, and a total of 160 cycles were completed. Among them, deGramont group and XELOX group had CR (0,0), PR (9 cases 30%, 15 cases 45.4% P = 0.023), SD (6 cases 20%, 12 cases 36.4% P = 0.036) (50%; 6 patients 18.2% P = 0.015), the total effective rate (RR () 30%; 45.5% P = 0.025). The median time to progression (TTP) was (3.6 months; 5.4 months, P = 0.038) and the median survival time (0s) was (7.4 months; 8.9 months, P = 0.024). The main adverse reactions were nausea, vomiting and bone marrow suppression. There was no significant difference between the two groups. The incidence of hand-foot syndrome and peripheral nerve injury in XELOX group was significantly higher than that in de Gramont group (P = 0.013). Other adverse reactions were tolerable. After symptomatic treatment improved. Conclusion: Oxaliplatin combined with capecitabine has a good curative effect in the treatment of advanced gastric cancer. Toxicity and side effects can be tolerated. It is worth further study.