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目的评价羟基喜树碱治疗奥沙利铂不耐受胃癌患者的疗效。方法将胃癌术后患者34例随机分为治疗组及对照组各17例。治疗组给予羟基喜树碱+亚叶酸钙+氟尿嘧啶治疗,对照组给予奥沙利铂+亚叶酸钙+氟尿嘧啶治疗。观察2组临床疗效及不良反应发生情况。结果 2组有效率及疾病控制率比较差异均无统计学意义(P>0.05)。治疗组在化疗期间出现远处转移2例,半年内死亡。对照组在化疗期间出现远处转移3例,半年内死亡。治疗组患者均完成6次化疗,平均无病生存期15.7个月。对照组7例完成6次化疗,其中2例持续指端麻木、感觉异常,4例完成4次化疗,2例完成3次化疗,平均无病生存期15.3个月,2组发热、骨髓抑制、恶心、呕吐、腹泻发生率比较差异无统计学意义(P>0.05)。治疗组外周神经病变发生率低于对照组,差异有统计学意义(P<0.05)。结论羟基喜树碱对胃癌患者的疗效等同于奥沙利铂,但对周围神经损害轻,疗效肯定。
Objective To evaluate the efficacy of hydroxycamptothecin in the treatment of patients with gastric cancer refractory to oxaliplatin. Methods 34 cases of postoperative gastric cancer patients were randomly divided into treatment group and control group of 17 cases. The treatment group was given hydroxycamptothecin + leucovorin + fluorouracil, and the control group was given oxaliplatin + leucovorin + fluorouracil. The clinical efficacy and adverse reactions of the two groups were observed. Results There was no significant difference in the effective rate and disease control rate between the two groups (P> 0.05). Two cases of distant metastasis occurred in the treatment group during chemotherapy, and died within six months. In the control group, 3 patients showed distant metastasis during chemotherapy and died within six months. Patients in the treatment group completed 6 chemotherapy, with an average disease-free survival of 15.7 months. In the control group, 7 patients completed 6 chemotherapy, 2 of them continued numbness and sensory abnormalities, 4 patients completed 4 cycles of chemotherapy, 2 patients completed 3 cycles of chemotherapy with an average disease-free survival of 15.3 months, 2 cases of fever, bone marrow suppression, Nausea, vomiting, diarrhea incidence was no significant difference (P> 0.05). The incidence of peripheral neuropathy in the treatment group was lower than that in the control group, with significant difference (P <0.05). Conclusion Hydroxycamptothecin has the same curative effect on gastric cancer as oxaliplatin, but it is less damaging to peripheral nerves and has a definite curative effect.