Objective:To evaluate the efficacy and safety of pemetrexed combined with oxaliplatin and paclitaxel liposome combined with S -1 in the second -line chemotherapy of advanced gastric cancer.Methods:A total of 60 patients with advanced gastric cancer were randomly divided into two groups.There were 28 patients in group A(pem-etrexed 500mg/m2 iv d1 ,oxaliplatin 85mg/m2 iv d1 )and 32 patients in group B (paclitaxel liposome 135mg/m2 iv d1 , S -1 40mg/m2 bid d1 ~14 ).Both two regimens were 21 days as a cycle,and a total of 2 cycles were applied.The effi-cacy and side effects were evaluated after 2 cycles.Results:Patients in group A received 4 PR,9 SD,15 PD to con-trast group B 6 PR,12 SD,14 PD,in both two groups had no CR case.No statistical difference was found between the two groups in regard to response rate(14.29% vs 18.75%),disease control rate(46.43% vs 56.25%)and TTP(5. 8 months vs 6.2 months).The group A had higher frequency of hypodynamia,skin eruption and alopecia (P <0. 05),while the group B had higher frequency of leukocyte and thrombocytopenia(P <0.05).Conclusion:Pemetrexed combined with oxaliplatin and paclitaxel liposome combined with S -1 are effective and tolerated,can be used as two palliative treatment for advanced gastric cancer.%目的：观察培美曲塞联合奥沙利铂方案和紫杉醇脂质体联合替吉奥方案在晚期胃癌二线治疗中的近期疗效和安全性。方法：经病理组织学或细胞学确诊的60例晚期胃癌患者随机分为两组，A 组28例（培美曲塞500mg／m2 iv d1，奥沙利铂85mg／m2 iv d1），B 组32例（紫杉醇脂质体135mg／m2 iv d1，替吉奥40mg／m2 bid d1～14），21天为1周期，2周期后评价疗效及不良反应发生情况。结果：60例患者均可评价疗效，A 组和 B 组有效率分别是14．29％和18．75％（P ＞0．05），疾病控制率分别是46．43％和56．25％（P ＞0．05），中位 TTP 分别为5．8个月和6．2个月（P ＞0．05）。化疗不良反应总体上均可耐受，A 组乏力、皮疹和脱发发生率为78．57％、35．71％和25．0％（P ＜0．05），B 组白细胞减少、血小板减少发生率分别为68．75％和62．50％（P ＜0．05）。结论：培美曲塞联合奥沙利铂方案和紫杉醇脂质体联合替吉奥方案二线治疗晚期胃癌的近期疗效相当，不良反应可耐受，可以作为晚期胃癌的有效姑息治疗方案。
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