卡培他滨联合奥沙利铂治疗晚期胃癌的临床观察(1)
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[摘要] 目的 观察卡培他滨联合奥沙利铂治疗晚期胃癌的疗效和毒性反应。 方法 将50例晚期胃癌患者随机分为A组和B组，每组各25例。A组：卡培他滨1 000 mg/m2，每天2次口服，d1～14；奥沙利铂130 mg/m2，静脉滴注2 h，d1。B组：亚叶酸钙200 mg/d，静脉滴注2 h，d1～5；5-Fu 750 mg/d，缓慢静脉滴注2 h，d1～5；奥沙利铂130 mg/m2，静脉滴注2 h，d1。上述疗法3周为1个周期。 结果 两组疗效比较，差异无统计学意义(P > 0.05)，A组消化系统毒性反应明显低于B组(P < 0.01)。 结论 卡培他滨联合奥沙利铂治疗晚期胃癌可在临床上推广应用。
[关键词] 卡培他滨；奥沙利铂；晚期胃癌；联合化疗
[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210(2012)02(c)-0058-02
Clinical observation of chemotherapy of Capecitabine combined with Oxaliplatin in treatment of advanced gastric cancer
WANG Aiying ZHANG Maojiang
Department of Internal Medicine, the Second People′s Hospital of Hebi City, He′nan Province, Hebi 458030, China
[Abstract] Objective To observe the efficacy and toxicity of the chemotherapy of Capecitabine combined with Oxaliplatin in treatment of patients with advanced gastric cancer. Methods 50 patients with advanced gastric cancer were randomly divided into group A and group B, with 25 cases respectively. Group A: Capecitabine 1 000 mg/m2, po, bid, d1-14; Oxaliplatin 130 mg/m2, ivgtt (2 h), d1; Group B: Leucovorin 200 mg/d, ivgtt (2 h), d1~5; Fluorouracil 750 mg/d, ivgtt (8 h), d1-5; Oxaliplatin 130 mg/m2, ivgtt (2 h), d1. They were repeated every 3 weeks. Results The differences in clinical efficacy were not obvious between the two groups (P > 0.05). The toxicity of digestive systemtoxicity in group A was obviously milder than the toxicity in group B (P < 0.01). Conclusion The chemotherapy of Capecitabine combined with Oxaliplatin is worthwhile to be applied widely in treatment of patients with advanced gastric cancer.
[Key words] Capecitabine; Oxaliplatin; Advanced gastric cancer; Combined chemotherapy
早期胃癌以手术治疗为主，中晚期胃癌的治疗手段主要是化疗。在过去的几十年中，5-氟尿嘧啶(5-Fu)是胃癌化疗的基本药物。卡培他滨是一种新型的口服5-Fu前体药物，它能在肿瘤组织里转变为5-Fu而发挥细胞毒作用。研究表明[1-3]，卡培他滨单药治疗晚期胃癌的客观有效率为19.4%～34.0%。联合化疗可使晚期胃癌的有效率显著提高，有研究应用卡培他滨联合奥沙利铂一线治疗晚期胃癌的有效率为46.7%[4]。本文中笔者将2009年9月~2011年9月收集的50例晚期胃癌患者随机分为两组，A组用卡培他滨(Capecitabine)联合奥沙利铂(OXA)进行化疗(OX方案)，B组用5-Fu和亚叶酸钙(LV)联合奥沙利铂进行化疗(OFu/LV方案)，现将观察结果报道如下：
1 资料与方法
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