摘要
目的:观察沙利度胺(Thalidomide)联合草酸铂(L-OHP)、亚叶酸钙(CF)、氟脲嘧啶(5-FU)和羟基喜树碱(HCPT)持续给药治疗晚期胃癌的近期疗效及其对生活质量的影响。方法:采用随机分组的方法将41例晚期胃癌患者分为联合用药组(22例),与化疗组(19例)。联合用药组:沙利度胺,起始剂量第1周100 mg/d,晚睡前顿服,如能耐受毒副反应,每周增加100 mg,直至目标剂量300 mg/d维持,如不能耐受加量者,则维持原剂量,至少口服>2个月;L-OHP 85 mg/m2,静脉滴入2 h,d1;CF200 mg/m2,静脉滴入2 h,d1～d2;5-FU400 mg/m2,静脉推注,d1～d2,5-FU600 mg/m2,持续静脉滴入22 h,d1～d2;HCPT 5 mg,持续静脉滴入24 h,d1～d5。化疗组:不加入沙利度胺,其他用法同联合用药组。结果:联合用药组有效率50.0%(11/22),化疗组有效率42.1%(8/19),联合用药组有效率高于化疗组,但两组差异无统计学意义,P>0.05。联合用药组的临床受益率为77.3%(17/22),化疗组为52.6%(10/19),两组差异有统计学意义,P<0.05。联合用药组KPS评分的改善率为68.2%(15/22),化疗组的改善率为36.8%(7/19),两组差异有统计学意义,P<0.05。联合用药组的恶心呕吐发生率较化疗组低,两组差异有统计学意义,P<0.05。其余毒副反应均相似。结论:与单用化疗相比,沙利度胺联合化疗能提高晚期胃癌患者的临床受益率,同时改善患者的生活质量。
OBJECTIVE：To observe the clinical efficacy and quality of life of thalidomide combined with oxaliplatin,leucovorin,fluorouracil and hydroxycamptothecin for advanced gastric cancer.METHODS：In a randomized manner,41 patients with advanced gastric cancer were divided into a combined treatment group and chemotherapy group.Combined treatment group：thalidomide 100 mg/d,or,first week,and increased by 100 mg every week until 300 mg/d if side effect was tolerance,if not keep 100 mg/d for more than 2 months;L-OHP 85 mg/m2,iv drip 2 h,d1;CF 200 mg/m2,iv drip 2 h,d1-d2;5-FU 400 mg/m2,iv,and then 600 mg/m2,iv drip 22 h,d1-d2;HCPT 5 mg,iv drip 5 h,d1-d5.Chemotherapy group：the same as combined group without thalidomide.The clinical efficacy and quality of life were compared between two groups.RESULTS：The overall response rates in the combined treatment group and chemotherapy group were 50.0%（11/22） and 42.1%（8/19）,respectively.The overall response to the combined treatment group was higher than that of the chemotherapy group,but there were no statistically significant difference between two groups（P0.05）.The clinically profited rates were 77.3%（17/22） and 52.6%（10/19）,respectively.There was a statistically significant difference between two groups（P0.05）.The improvement rates of Karnofsky score were 68.2%（15/22） and 36.8%（7/19）,respectively.There was a statistically significant difference between two groups（P0.05）.Nausea and vomiting were more pronounced in the chemotherapy group（P0.05）.Other toxicities were similar.CONCLUSION：Compared with the chemotherapy regimen,thalidomide combined with chemotherapy regimen obviously increase the clinically profiting rate and improve the life quality of patients with advanced gastric cancer.
出处
《中华肿瘤防治杂志》
CAS
2010年第21期1768-1770,共3页
Chinese Journal of Cancer Prevention and Treatment
