摘要
目的探讨氟尿嘧啶类药物化疗失败后多西他赛联合顺铂(DP)和伊立替康联合顺铂(IP)方案二线治疗进展期胃癌的疗效。方法回顾性分析接受氟尿嘧啶类药物基础化疗失败的进展期胃癌患者120例,按照二线治疗方案的不同,分为DP组与IP组。DP组65例,行多西他赛联合顺铂化疗,IP组55例,行伊立替康联合顺铂化疗。比较两组患者临床疗效、生活质量、不良反应、以及生存情况。结果 DP组临床有效率与控制率分别为27.69%、56.92%,与IP组的21.82%、52.73%比较,无统计学差异(P>0.05)。两组治疗后体质量与卡氏评分均较同组治疗前明显上升(P<0.05),但两组比较,无统计学差异(P>0.05)。两组白细胞减少、血小板减少、血红蛋白减少、恶心、呕吐、乏力、肝功能损害、神经毒性发生率比较,无统计学差异(P>0.05);DP组腹泻、胆碱能综合征发生率分别为9.23%、0,明显低于IP组的65.45%、10.91%(P<0.05),脱发、口腔黏膜炎发生率分别为100.00%、49.23%,明显高于IP组的38.18%、25.45%(P<0.05)。截至2016年10月31日,DP组生存5例,IP组生存4例。DP组中位肿瘤无进展生存期为4.1个月,IP组为4.5个月;DP组中位生存期为6.1个月,IP组为5.8个月,两组患者中位肿瘤无进展生存期与中位生存期比较,无统计学差异(P>0.05)。结论对氟尿嘧啶类药物基础化疗失败后的进展期胃癌患者行多西他赛联合顺铂或伊立替康联合顺铂方案二线治疗疗效相近,能明显提升患者生活质量,且不良反应小。
Objective To explore the efficacy of docetaxel combined with cisplatin （DP） and irinotecan combined with cisplatin （IP） as second-line treatment for advanced gastric cancer failed fluorouraeil chemotherapy. Methods 120 cases of ad- vanced gastric cancer patients who had failed fluorouracil chemotherapy were retrospectively analyzed. According to the different second-line treatment options,they were divided into DP group and IP group. DP group had 65 patients, they received docetaxel plus cisplatin chemotherapy, 55 IP group had 55 patients, they received irinotecan combined with cisplatin chemotherapy. The clinical efficacy, quality of life, adverse reactions, and survival of the 2 groups were compared. Results The clinical efficiency and control rate of DP group were respectively 27, 69% and 56.92% ,and of IP group were 21.82% and 52.73% ,there was no significant difference （ P 〉 0.05 ）. After treatment, body mass and the Karnofsky score of the 2 groups were significantly increased （P 〈 0.05 ）, but there was no statistical difference between the 2 groups （P 〉 0.05 ）. There was no significant difference between the 2 groups in leukopenia, thrombocytopenia, reduction of hemoglobin, nausea, vomiting, fatigue, liver function impairment, neuro- toxicity （P 〉 0.05 ）. Diarrhea and cholinergic syndrome incidence rates of DP group were 9.23% and 0% , which were signifi- cantly lower than IP group of 65.45% ,10.91% （ P 〈 0.05 ） , alopecia and mucositis incidence rates were 100% and 49.23% , which were significantly higher than IP group of 38.18% ,25.45% （P 〈0.05）. By October 31 2016,5 patients in the DP group were alive, and 4 patients in the IP group were alive. Median progression-free survival time of DP group was 4.1 months, IP group was 4.5 months ; median overall survival time of DP group was 6.1 months, IP group was 5.8 months. There was no significant difference in median progression-free survival time and median overall survival time between the 2 groups （P 〉 0.05 ）. Conclusion IP and DP as second-line treatment for advanced gastric cancer failed fluorouracil chemotherapy have similar efficacy,it can evi- dently increase the quality of life of patients, and the adverse reaction is small.
出处
《实用癌症杂志》
2017年第6期992-995,共4页
The Practical Journal of Cancer
关键词
多西他赛
伊立替康
顺铂
二线治疗
进展期胃癌
Irinotecan
Docetaxel
Cisplatin
Second-line treatment
Advanced gastric cancer
