多西他赛联合替吉奥治疗老年晚期胃癌预后分析

摘要

Objective To investigate the efficacy and toxicity of docetaxel plus S -1 in the treatment of unresectable advanced gastric cancer in elderly patients.Methods A total of 58 elderly patients with unresectable advanced gastric cancer with different treatments were retrospectively analyzed.The patients were divided into 2 groups according to differ-ent regimens.The docetaxel plus S -1 group (DT group, n =27) received intravenous infusion of docetaxel at 75 mg/m 2 on day 1 and oral S -1 at 40 -60 mg twice daily on days 1 -14 of a 21 -day cycle.The S -1 alone group (S -1 group, n =31) received oral S -1 at 40 -60 mg twice daily on days 1 -14 of a 21 -day cycle.The clinical efficacy and toxicity were observed after 4 cycles.Results All of the 58 patients received clinical outcome evaluation, the effective rate of the DT group was obviously higher than that of the S -1 group (51.9% vs.16.1%, P <0.01).The median overall survival (OS) time was longer in the DT group than in the S -1 group (14.4 months vs.11.5 months, P <0.05).The median of progression -free survival (PFS) time was also longer in the DT group than in the S -1 group (8.9 months vs.7.1 months, P <0.05).The main adverse events were nausea, vomiting, anemia, leucopenia, and thrombocytope-nia in both groups without significant statistical difference (P >0.05).Conclusion The combination of docetaxel and S-1 is well tolerated and effective in the treatment of advanced gastric cancer, especially in poor physical condition of eld-erly patients.%目的：探讨多西他赛联合替吉奥治疗不可切除的老年晚期胃癌患者的有效性及安全性。方法回顾性分析58例接受化疗的晚期不可切除老年胃癌患者的临床资料。根据患者治疗方案不同分为2组。多西他赛联合替吉奥组（DT 组，27例）：多西他赛静脉滴注（75 mg／m 2），第1天；替吉奥胶囊40～60 mg／次，每天分2次饭后口服，第1～14天，21天为1个周期。单药替吉奥组（S －1组，31例）：替吉奥胶囊40～60 mg／次，每天分2次饭后口服，第1～14天，21天为1个周期。观察并记录近期疗效及不良反应，观察4个周期后进行统计学分析。随访记录患者总生存期（OS）及无进展生存期（PFS）。结果58例患者均可进行疗效评价，DT 组有效率明显高于 S －1组（51．9％ vs．16．1％， P ＜0．01）；DT 组、S －1组中位 OS 分别为14．4个月和11．5个月，中位 PFS 分别为8．9个月和7．1个月，DT 组中位 OS 及中位 PFS 均优于 S －1组（P ＜0．05）。2组不良反应均主要表现为恶心、呕吐、贫血、白细胞及血小板下降等，组间不良反应发生率差异无统计学意义（P ＞0．05）。结论多西他赛联合替吉奥治疗晚期胃癌具有较高的临床有效率，尤其适用于身体状况较差的老年晚期胃癌患者。