替吉奥联合静脉和腹腔化疗方案治疗胃癌腹水的临床观察

目的 观察口服国产替吉奥联合静脉(多西他赛)和腹腔(顺铂)化疗治疗晚期胃癌腹水的近期疗效及不良反应.方法 将56例晚期胃癌合并癌性腹水患者随机分为2组:治疗组28例采用口服替吉奥,联合静脉滴注多西他赛全身化疗和腹腔内灌注顺铂局部化疗方案;对照组28例采用持续静脉滴注氟尿嘧啶,联合与治疗组相同的静脉用多西他赛和腹腔灌注顺铂化疗方案;均3个周期后评价近期疗效、临床受益及不良反应.结果 56例均可评价;治疗组和对照组的腹水近期有效率(RR)、中位疾病进展时间(TTP)分别为78.6%(22/28)和6.4个月、67.9%(19/28)和5.9个月,差异均无统计学意义(P>0.05),但从数值上看治疗组似乎更有优势,且治疗组的临床受益反应(CBR)为92.9%(26/28),优于对照组的71.4%(20/28),差异有统计学意义(P<0.05);治疗组的不良反应及严重反应发生率均明显低于对照组(P<0.05).结论 含口服国产替吉奥联合静脉和腹腔化疗是治疗晚期胃癌腹水的有效手段,不良反应可以耐受,值得临床进一步推广应用.

Clinical observation of venous and intraperitoneal chemotherapy combined with S-1 in the treatment of gastric cancer patients with ascites

Objective:To evaluate the short-term efficacy and toxicity of the combination of venous(Docetaxol)and intraperitoneal(Cisplatin)chemotherapy together with homemade S-1 in the treatment of advanced gastric cancer patients with ascites.Methods: Total of 56 advanced gastric cancer patients with ascites were randomly divided into two groups.The experimental group was treated with S-1 by oral,combining with Docetaxol by venous(Systemic chemotherapy)and Cisplatin by intraperitoneal(Local chemotherapy)chemotherapy;the control group was treated with 5-FU by continuous intravenous drip,combining with Docetaxol by venous and Cisplatin by intraperitoneal chemotherapy.Short-term efficacy,clinical benefit response and adverse reactions were evaluated after three treatment cycles.Results: All patients can be evaluated.In the experimental group,the tumor response rate(RR)was 78.6%(22/28),and median time to progression(MTTP)was 6.4 months.The RR and MTTP in the control group was 67.9%(19/28)and 5.9 months,respectively.The difference between two groups was not statistical significant(P>0.05).However,in the experimental group,it showed a better clinical reaction from quantitative value and the clinical benefit response(CBR)was 92.9%(26/28),while the CBR in the control group was 71.4%(20/28).The difference between two groups was statistical significant(P<0.05).Besides,compared to the control group,the experimental group’s occurrence rate of adverse reactions and serious response were apparently lower(P<0.05).Conclusion: The regimens of venous and intraperitoneal chemotherapy combined with homemade S-1 showed better curative effect in the treatment of gastric cancer patients with ascites,and the toxicity is relatively mild and tolerable.These results indicate that further clinical study is worthy.