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目的比较体力状况评分偏低(KPS60-70)的老年胃癌患者一线应用替吉奥(S1)单药与奥沙利铂(LOHP)联合S-1方案的疗效及不良反应。方法经病理确诊的老年晚期胃癌患者84例,KPS60-70,均为一线治疗,随机分为观察组(S1单药)和对照组(LOHP+S1),观察其疗效、副反应及平均年治疗费用。结果 S-1单药组RR41.4%,略低于LOHP+S1组的45.0%,但差异无统计学意义。单药组及联合化疗组中位PFS、中位OS统计学分析无显著性差异。S1单药组血液性毒性、非血液学毒性发生率均明显轻于联合化疗组,有更高的生活质量。平均年治疗费用低,有更高的经济效益比。结论单药S1与LOHP联合S1相比在一线治疗中更适合国人老年体力状况评分60~70晚期胃癌患者。
Objective To compare the efficacy and side effects of first-line application of tioguanoside (S1) and oxaliplatin (LOHP) combined with S-1 in elderly patients with gastric cancer with low physical status score (KPS60-70). Methods Eighty-four elderly patients with advanced gastric cancer diagnosed by pathology and KPS60-70 were treated as first-line treatment and were randomly divided into observation group (S1 drug) and control group (LOHP + S1), and their efficacy, side effects and mean annual treatment cost. Results The RR of S-1 single group was 41.4%, slightly lower than that of LOHP + S1 group (45.0%), but the difference was not statistically significant. Median PFS and median OS in single drug group and combined chemotherapy group showed no significant difference. S1 single drug group of blood toxicity, non-hematologic toxicity were significantly lower than the combined chemotherapy group, have a higher quality of life. The average annual cost of treatment is low, a higher economic efficiency ratio. Conclusion Single-agent S1 and LOHP combined with S1 in first-line treatment is more suitable for Chinese elderly patients with physical status score 60 to 70 patients with advanced gastric cancer.