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目的:探讨奥沙利铂联合希罗达方案(XELOX)和紫杉醇联合氟尿嘧啶及顺铂(PCF)方案治疗晚期胃癌的疗效和毒副反应的比较。方法:对我科2005年5月至2007年10月间采用XELOX化疗方案及PCF治疗方案的晚期胃癌病例进行回顾性疗效及毒副反应的比较分析,XELOX组34例,PCF组31例。结果:XELOX方案组总有效率41·1%(15/34),临床受益率74·5(25/34)。生活质量提高,KPS评分增加10分。中位TTP为7·1个月。PCF方案组总有效率41。3%(12/29),临床受益率75·8(22/29)。生活质量轻度下降,KPS评分降低10分。中位TTP为6·9个月。两组间无显著性差异;TCF组的恶心、呕吐、骨髓抑制毒、肌肉酸痛等副反应高于XELOX方案组(P<0·01),XELOX方案组的外周神经毒性、手足综合征发生率明显高于PCF方案组(P<0·01)。结论:XELOX和PCF方案治疗晚期胃癌的疗效相近,毒副反应可耐受,但XELOX方案毒副反应方面患者耐受性更好,用药更方便,且在生活质量提高、中位TTP的提高方面有一定优势。
Objective: To investigate the curative effect and toxicity of oxaliplatin combined with Xelox and paclitaxel in combination with fluorouracil and cisplatin (PCF) in the treatment of advanced gastric cancer. Methods: Retrospective and comparative analysis of the side effects and side effects of advanced gastric cancer patients treated with XELOX chemotherapy and PCF from May 2005 to October 2007 in our department. 34 patients in XELOX group and 31 patients in PCF group. Results: The total effective rate in XELOX group was 41.1% (15/34), and the clinical benefit rate was 74.5 (25/34). Quality of life improved, KPS score increased by 10 points. Median TTP was 7.1 months. In the PCF group, the total effective rate was 41.3% (12/29) and the clinical benefit rate was 75.8 (22/29). Slight decline in quality of life, KPS score decreased by 10 points. Median TTP was 6.9 months. The side effects of nausea, vomiting, myelosuppression and muscle soreness in TCF group were higher than those in XELOX group (P <0.01). The incidence of peripheral neurotoxicity, the incidence of hand-foot syndrome in XELOX group Was significantly higher than the PCF program group (P <0.01). Conclusions: The efficacy of XELOX and PCF regimens in treating advanced gastric cancer is similar and their side effects are tolerable. However, patients with XELOX regimen have better tolerability and medication, and they are more effective in improving quality of life and improving the median TTP Have some advantages.