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目的评估替吉奥(S-1)联合奥沙利铂化疗方案治疗复发、转移性胃癌患者的疗效及不良反应。方法选择2007年4月至2011年6月本院收治的复发、转移性胃癌患者,共38例,随机分为替吉奥联合奥沙利铂治疗组(n=19)和顺铂联合氟尿嘧啶对照组(n=19),所有患者均至少接受2个疗程化疗。参照实体瘤疗效评价标准(RECIST),通过治疗后部分缓解(PR)、病情稳定(SD)和病情进展(PD)情况,以及疾病进展时间(TTP)和中位生存时间(MST)等评估疗效,并观察不良反应。结果治疗组8例为PR,6例为SD,5例为PD,有效率为42.10%,疾病控制率为73.68%,TTP为8.3个月,MST为10.7个月;对照组6例为PR,5例为SD,8例为PD,有效率为31.58%,疾病控制率为57.59%,TPP为7.1个月,MST为8.2个月。两组间有效率、疾病控制率、TTP及MST差异均具有统计学意义(P<0.05)。两组患者主要不良反应为骨髓抑制、胃肠道反应及外周神经毒性,治疗组Ⅲ/Ⅳ级不良反应发生率显著低于对照组(8.5%对17.6%,P<0.05)。结论替吉奥联合奥沙利铂化疗方案治疗复发、转移性胃癌,临床获益率较高,不良反应较轻,患者耐受良好。
Objective To evaluate the efficacy and side effects of treatment of tegaserod (S-1) combined with oxaliplatin in patients with recurrent and metastatic gastric cancer. Methods A total of 38 patients with recurrent and metastatic gastric cancer admitted to our hospital from April 2007 to June 2011 were randomly divided into two groups: treatment with tegaserod combined with oxaliplatin (n = 19) and cisplatin plus fluorouracil Group (n = 19). All patients received at least 2 cycles of chemotherapy. The response to solid tumors (RECIST) was evaluated by partial response (PR), stable condition (SD) and progression of disease (PD), as well as time to progression (TTP) and median survival time (MST) , And observed adverse reactions. Results In the treatment group, 8 cases were PR, 6 cases were SD, 5 cases were PD, the effective rate was 42.10%, disease control rate was 73.68%, TTP was 8.3 months, MST was 10.7 months; 5 cases were SD, 8 cases were PD, the effective rate was 31.58%, disease control rate was 57.59%, TPP was 7.1 months and MST was 8.2 months. Efficacy, disease control rate, TTP and MST differences between the two groups were statistically significant (P <0.05). The main adverse reactions of the two groups were myelosuppression, gastrointestinal reaction and peripheral neurotoxicity. The incidence of grade Ⅲ / Ⅳ adverse reactions in the treatment group was significantly lower than that in the control group (8.5% vs 17.6%, P <0.05). Conclusion The treatment of recurrent and metastatic gastric cancer with the combination of ticlopidine and oxaliplatin chemotherapy has higher clinical benefit, less adverse reactions and good tolerability.