胃癌奥沙利铂和替吉奥_奥沙利铂联合替吉奥或卡培他滨治疗老年晚期胃癌的临床观察

　　[摘要] 目的 对比分析奥沙利铂联合替吉奥或卡培他滨联合化疗方案治疗老年晚期胃癌的疗效和不良反应。 方法 72例老年晚期胃癌患者，其中31例接受奥沙利铂联合替吉奥方案化疗（SOX组，奥沙利铂130 mg/m2，静脉滴注2 h，第1天；替吉奥40 mg/m2，口服，2次/d，连用14 d，每3周重复）；41例接受奥沙利铂联合卡培他滨方案治疗（XELOX组，奥沙利铂130 mg/m2，静脉滴注2 h，第1天；卡培他滨1 200 mg/m2，口服，2次/d，连用14 d，每3周重复）。 结果 SOX组总有效率为43.33%，XELOX组总有效率为41.03%，差异无统计学意义（P ＞ 0.05）；SOX组无手足综合征发生，XELOX组手足综合征发生率为17.07%，差异有统计学意义（P ＜ 0.05）；其余毒副作用，如白细胞下降、贫血、乏力、恶心呕吐、肝毒性等相似，差异无统计学意义（P ＞ 0.05）。 结论 奥沙利铂联合替吉奥或卡培他滨方案治疗老年晚期胃癌，效果基本相似，奥沙利铂手足综合征发生率较高，但患者基本耐受。氟尿嘧啶口服剂型，有利于提高老年患者的化疗依从性，改善患者生活质量。
　　[关键词] 胃癌；替吉奥；卡培他滨；奥沙利铂
　　[中图分类号] R735.7 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0061-03
　　Clinical observation of Oxaliplatin combined with Gimeracil or Capecitabine in the treatment of advanced gastric cancer in elderly patients
　　LU Huifang1 ZHANG Yanxin2 HAN Lili1 CHEN Beibei1 WANG Xinfeng1 LUO Suxia1 CHEN Xiaobing1
　　1.Department of Medical Oncology, the Tumor Hospital Affiliated to Zhengzhou University, He"nan Province, Zhengzhou 450008, China; 2.Department of Pathology, Luohe Medical College, He"nan Province, Luohe 462000, China
　　[Abstract] Objective To compare the therapeutic efficacy and adverse reactions of chemotherapy of Oxaliplatin combined with Gimeracil or Capecitabine in the treatment of advanced gastric cancer in elderly patients. Methods 31 cases of patients were treated with Oxaliplatin combined with Gimeracil (SOX group, in 1st day, intravenous injection of 130 mg/m2 Oxaliplatin for 2 hours; oral administration of 40 mg/m2 Gimeracil twice a day for 14 days, repeated every 3 weeks); 41 patients were given Oxaliplatin combined with Capecitabine (XELOX group, in 1st day, intravenous injection of 130 mg/m2 Oxaliplatin for 2 hours; oral administration of 200 mg/m2 Capecitabine twice a day for 14 days, repeated every 3 weeks). Results Total effective rate was 43.33% in the SOX group and 41.03% in the XELOX group, and were not significantly different between the two groups (P ＞ 0.05); and there were no cases of hand-foot syndrome in SOX group, while hand-foot syndrome incidence rate was 17.07% in the XELOX group, and were significantly different between the two groups (P ＜ 0.05); incidences of other side effects, such as leukopenia, anemia, fatigue, nausea, vomiting and liver toxicity, were not significantly different between the two groups (P ＞ 0.05). Conclusion Oxaliplatin combined with Gimeracil or Capecitabine has similar treatment efficacy in the treatment of elderly patients with advanced gastric cancer. Oxaliplatin treatment generally has high incidence of hand-foot syndrome, but patients basically can tolerate the side effects. Fluorouracil can improve compliance of elderly patients and improve patients" quality of life.