多西他赛、奥沙利铂联合替吉奥（DOS）与奥沙利铂联合替吉奥（SOX）治疗晚期胃癌的临床观察

摘要

Objective:To evaluate the efficacy and safety of Docetaxel/S-1/Oxaliplatin( DOS)and S-1/Oxali-platin( SOX)for the treatment of AGC. Methods:In a retrospective study,71 patients with AGC were analyzed. The patients were divided into two groups according to the regimen received:DOS group(36 cases)and SOX group(35 cases). In the DOS group,all patients received oral S-1 30mg/m2 ,twice daily,d1-14 . On d1 of every cycle,Oxalipla-tin 100mg/m2 was administered intravenously,and Docetaxel 60mg/m2 was administered. In the SOX group,all pa-tients received oral S-1 40mg/m2 ,twice daily,d1-14 . On d1 of every cycle,Oxaliplatin 130mg/m2 was administered intravenously,every 21 days. The efficacy and toxicity were evaluated after at least two consecutive courses. Results:All patients were evaluated for efficacy and safety. In the DOS group:CR 1 case(2. 8%),PR 16 cases(44. 4%),SD 10 cases(27. 8%),the response rate(RR)was 47. 2%,disease control rate(DCR)was 75%,and the median pro-gression free survival(PFS)time was 4. 4 months. In the SOX group:CR 0 case,PR 15 cases(42. 9%),SD 13 cases (37. 1%),the RR was 42. 9%,DCR was 80%,and the median PFS time was 4 months. The response rate,disease control rate and the median progression free survival were not significantly different between two groups(p>0. 05).Myelosuppression,gastrointestinal reaction,alopecia and sensory neuropathy were the most common adverse events ob-served in both groups. There were significantly more alopecia in the DOS group than in the SOX group(p<0. 001). There were significantly more sensory neuropathy in the SOX group than in the DOS group(p=0. 005). Conclusion:Both DOS and SOX are effective and well-tolerated for the treatment of advanced gastric cancer.%目的：观察多西他赛、奥沙利铂联合替吉奥（ DOS）与替吉奥联合奥沙利铂（ SOX）方案一线治疗晚期胃癌的近期疗效和安全性。方法：回顾性分析71例晚期胃癌患者，根据患者所接受的化疗方案分为DOS组（36例）和SOX组（35例）。DOS组：多西他赛60mg/m2静脉滴注1h，第1天；奥沙利铂100mg/m2静脉滴注3h，第1天；替吉奥胶囊（ S-1）30mg/m2，口服，每日2次，第1-14天，每21天为1个周期。SOX组：奥沙利铂130mg/m2静脉滴注3h，第1天；替吉奥40mg/m2，口服，每日2次，第1-14天，每21天为1个周期。连用2个周期后评价疗效和每个周期观察不良反应。结果：所有患者均可评估疗效，DOS组CR 1例（2.8%），PR 16例（44.4%），SD 10例（27.8%），有效率（RR）为47.2%，疾病控制率（DCR）为75.0%，中位无进展生存期（PFS）4.4个月。SOX组CR患者0例，PR 15例（42.9%），SD 13例（37.1%），有效率为42.9%，疾病控制率为80%，中位无进展生存期4.0个月。两组的客观有效率、疾病控制率及中位无进展生存期差异均无统计学意义（ p>0.05）。化疗主要不良反应为骨髓抑制、胃肠道反应、脱发和周围神经病变。其中，脱发发生率DOS组显著高于SOX组（p<0.001）；I/II级周围神经毒性，SOX组发生率显著高于DOS组（p=0.005）。结论：DOS和SOX化疗方案治疗进展期胃癌疗效相近，不良反应均可耐受。