替吉奥联合紫杉醇或奥沙利铂治疗进展期胃癌的临床观察

目的 观察替吉奥（S-1）联合紫杉醇或奥沙利铂一线治疗进展期胃癌的临床疗效和不良 反应。方法 91例进展期胃癌患者分为替吉奥联合奥沙利铂(SOX组)和紫杉醇(PS组)方案化疗，其 中SOX组44 例，PS组47例。所有患者S-1均是80 mg/m2，分2次餐后口服，d1~d14；SOX组：奥沙 利铂 130 mg/m2，d1，静脉滴注；PS组：紫杉醇 80 mg/m2，d1、8，静脉滴注。均21天为1周期。结 果 SOX组和PS组的有效率分别为36.4%和40.4%(P=0.691)，两组的中位无疾病进展时间(5.0月 vs. 5.4 月，P=0.45)和中位生存时间(13.5月 vs. 16.4月，P=0.76)无显著差异。SOX组和PS组的不良反应主要 是中性粒细胞减少、胃肠道反应、乏力；SOX组和PS组的恶心、呕吐发生率分别为79.5％和51.1％(P ＜0.05)。结论 替吉奥联合紫杉醇或奥沙利铂治疗进展期胃癌有效率和生存期相当，均有较好的疗 效，不良反应可以耐受。

Clinical Observation of S-1 Combined with Oxaliplatin or Paclitaxel on Advanced Gastric Cancer

Objective To observe the efficacy and adverse reaction of S-1 combined with oxaliplatin or paclitaxel in the treatment of advanced gastric cancer. Methods Ninety-one advanced gastric carcinoma patients were divided into two groups: SOX group(44 cases, S-1 plus oxaliplatin) and PS group (47 cases, S-1 plus paclitaxel). All cases took oral S-1, 80 mg/m2/day, d1~14; Moreover, SOX group took oxaliplatin, 130 mg /m2 on d1; PS group took paclitaxel, 80mg /m2 on d1, d8. 21 days was a cycle. Results RR in group SOX and PS were 36.4% and 40.4% (P=0.691), respectively. PFS was 5.0 months in SOX group and 5.4 months in PS group (P=0.45). OS was 13.5 months in SOX group and 16.4 months in PS group (P=0.76). Main adverse effects in two groups were neutropenia, gastrointestinal reaction and fatigue. The frequency of nausea and vomiting was 79.5% in SOX group and 51.1% in PS group(P＜0.05). Conclusion RR and OS of S-1 combined with SOX or PS were similar, with good curative effect and tolerable adverse reactions.