紫杉醇联合奥沙利铂及低剂量替吉奥治疗老年晚期贲门癌的近期疗效及安全性分析

摘要

目的 分析观察紫杉醇联合奥沙利铂及低剂量替吉奥治疗老年晚期贲门癌的临床疗效和安全性.方法 选取78例经病理学确诊的老年晚期贲门癌患者,按治疗方法不同分为A、B、C 3组,每组各26例,A组为紫杉醇联合奥沙利铂及低剂量替吉奥治疗,B组为低剂量替吉奥联合奥沙利铂治疗,C组为高剂量替吉奥联合奥沙利铂治疗,每组均21 d为1个周期,药物治疗2个周期后观察每组的临床疗效及不良反应发生情况.结果 A、B、C 3组的近期化疗有效率分别为19.2%、19.2%、11.5%,疾病控制率分别为92.3%、84.6%、84.6%,差异均无统计学意义(P﹥0.05);A组的整体疗效高于B、C两组(P﹤0.05).A、B、C 3组的化疗不良反应主要表现为血液系统和消化道系统不良反应,如贫血、血小板减少、便秘、腹泻等,其中A组的贫血、血小板减少、中性粒细胞缺乏、恶心呕吐、便秘、腹泻的发生率低于B、C组,差异有统计学意义(P﹤0.05).结论 紫杉醇联合奥沙利铂及低剂量替吉奥治疗老年晚期贲门癌的总体临床有效率高,不良反应小,在老年晚期贲门癌患者中应予以推广.%Objective To analyze the clinical efficacy and safety of paclitaxel combined with oxaliplatin and low-dose S-1 in the treatment of elderly patients with advanced gastric cardia carcinoma. Method 78 cases of elderly pa-tients with advanced gstric cardia carcinoma confirmed by pathology were divided into group A, B and C according to their treatment modes, with 26 cases in each group. Patients in group A were given paclitaxel combined with oxaliplatin and low-dose S-1, those in Group B were treated with low-dose S-1 combined with oxaliplatin, while those in group C were given high-dose S-1 combined with oxaliplatin. For all the groups, each cycle of chemotherapy lasts 21 days, and the clinical efficacy and the incidences of adverse reactions in each group were observed after two cycles of treatment. Re-sult The short-term efficacy rates of chemotherapy in groups A, B and C were 19.2%, 19.2%and 11.5%respectively, and the corresponding disease control rates were 92.3%, 84.6%and 84.6%, the differences didn't reach statistical signifi-cance(P>0.05). However, the clinical efficacy of group A was higher than group B and group C(P<0.05). The adverse re-actions after chemotherapy of group A, B and C were mainly blood and digestive system disorders, such as anemia, thrombocytopenia, constipation and diarrhea. The incidences of anemia, thrombocytopenia, neutropenia, nausea and vom-iting, constipation and diarrhea of group A were lower than those in group B and C, and the differences reached statistical significance(P<0.05). Conclusion The chemotherapy of paclitaxel combined with oxaliplatin and low-dose of S-1 in treating elderly patients with advanced gastric cardia carcinoma showed higher clinical efficacy and fewer adverse reac-tions, thus should be promoted in patients with advanced gastric cardia carcinoma.