多西他赛为主的三药方案治疗高龄低分化胃癌的效果观察

目的分析以多西他赛为主的三药方案治疗高龄低分化胃癌患者的临床效果。方法随机数表法将91例高龄低分化胃癌患者随机分组对照组(n=45)和观察组(n=46),对照组患者接受多西他赛^+奥沙利铂方案化疗,观察组患者接受多西他赛^+奥沙利铂^+替吉奥方案化疗,比较两组患者的外周血T淋巴细胞(包括CD8^+、CD4^+、CD3^+)水平、临床疗效、生存情况及不良反应发生情况。结果治疗前后,两组患者CD3^+、CD4^+和CD8^+水平比较,差异均无统计学意义(P﹥0.05);治疗后,两组患者CD3^+、CD4^+和CD8^+水平均高于本组治疗前,差异均有统计学意义(P﹤0.05)。观察组患者疾病控制率(DCR)为56.5%(26/46),与对照组患者的51.1%(23/45)比较,差异无统计学意义(χ^2=0.268,P﹥0.05)。两组患者肿瘤进展时间和生存时间比较,差异均无统计学意义(P﹥0.05)。观察组患者中性粒细胞减少、白细胞减少、血小板减少、疲劳、脱发的发生率均高于对照组患者,差异均有统计学意义(P﹤0.05)。结论多西他赛为主的二药、三药方案治疗高龄低分化胃癌的临床效果相当,但三药方案的不良反应较重,考虑到高龄患者的身体条件,采用以多西他赛为主的二药方案治疗更为合适。

Effect of docetaxel-containing triplet chemotherapy in elderly patients with poorly differentiated gastric cancer

Objective To analyze the clinical effect of docetaxel-containing triplet chemotherapy in the treatment of elderly patients with poorly differentiated gastric cancer.Method This research included 91 elderly patients with poorly differentiated gastric cancer,who were randomized as control group(n=45)or study group(n=46),treated with the doublet regimen of docetaxel+oxaliplatin or triplet regimen of docetaxel^+oxaliplatin^+tegio chemotherapy.The peripheral blood T lymphocytes(CD8^+,CD4^+,CD3^+)levels,clinical efficacy,survival and adverse reactions were compared between the two groups.Result There was no significant regarding the CD3^+,CD4^+and CD8^+levels between the two groups before and after treatment(P>0.05),though the peripheral blood T lymphocytes were increased in both groups after treatment(P<0.05).The disease control rate(DCR)in study group was 56.5%(26/46),similar to that in control group at 51.1%(23/45),with no statistically significant differences observed(χ^2=0.268,P>0.05).Both groups of patients had consistent time to tumor progression and survival(P>0.05).The incidence of neutropenia,leukopenia,thrombocytopenia,fatigue and alopecia in study group were significantly higher than that those in control group(P<0.05).Conclusion The clinical effect of docetaxel-containing doublet or triplet regimen are similar as administered for elderly patients with poorly differentiated gastric cancer,though the triplet regimen induces more severe toxicities,given the fragile physical conditions of elderly patients,docetaxel-containing doublet regimen is considered to be more suitable in clinical treatment of gastric cancer among elderly patients.