CAJ | 학술논문

目的：探讨晚期胃癌DCF方案一线化疗后继续替吉奥维持化疗疗效及不良反应。方法随机将60例既往DCF方案一线化疗4~6周期后疗效评价为无疾病进展的晚期胃癌患者分为维持组与对照组。维持组予替吉奥维持化疗（40 mg/m2，连续14 d，每21 d为一个周期），持续至疾病进展或者出现不能耐受毒性为止。对照组予最佳支持治疗。结果维持组的近期有效率（CR+PR）为33.3%，疾病控制率（CR+PR+SD）为73.3%，对照组的近期有效率为3.33%，疾病控制率为46.7%，两组比较差异有统计学意义（P<0.05）。维持组的中位疾病进展时间7.9月，较对照组6.8月延长（P<0.05）。两组中位生存期分别为13.8月和11.7月（P>0.05）。维持组主要毒副反应为恶心、呕吐、白细胞减少、手足综合征，无治疗相关死亡。结论 DCF方案一线治疗后继续替吉奥维持治疗晚期胃癌患者，提高近期有效率及疾病控制率，延缓疾病进展，不良反应可以耐受，值得临床进一步研究应用。
목적：탐토만기위암DCF방안일선화료후계속체길오유지화료료효급불량반응。방법수궤장60례기왕DCF방안일선화료4~6주기후료효평개위무질병진전적만기위암환자분위유지조여대조조。유지조여체길오유지화료（40 mg/m2，련속14 d，매21 d위일개주기），지속지질병진전혹자출현불능내수독성위지。대조조여최가지지치료。결과유지조적근기유효솔（CR+PR）위33.3%，질병공제솔（CR+PR+SD）위73.3%，대조조적근기유효솔위3.33%，질병공제솔위46.7%，량조비교차이유통계학의의（P<0.05）。유지조적중위질병진전시간7.9월，교대조조6.8월연장（P<0.05）。량조중위생존기분별위13.8월화11.7월（P>0.05）。유지조주요독부반응위악심、구토、백세포감소、수족종합정，무치료상관사망。결론 DCF방안일선치료후계속체길오유지치료만기위암환자，제고근기유효솔급질병공제솔，연완질병진전，불량반응가이내수，치득림상진일보연구응용。
Objective To investigate the efficacy and adverse effect of DCF regimen with subsequent S-1 maintenance chemotherapy in patients with advanced gastric cancer (AGC). Methods Sixty AGC patients without disease progression after 4 to 6 cycles of DCF regimen as the first-line chemotherapy were randomized into maintenance group and control group (30 patients each). The patients in the maintenance group received maintenance chemotherapy with S-1 (40 mg/m2, twice daily for 14 days; 21 days for a treatment cycle) until disease progression or with intolerant toxicity, and those in the control group received optimal supportive care. Results The response rate (CR+PR) was 33.3%in the maintenance group, significantly higher than that in the control group (3.33%, P<0.05), and the disease control rate (CR+PR+SD) also differed significantly between the two groups (73.3% vs 46.7%, P<0.05). The median time to progression was 7.9 months in the maintenance group and 6.8 months in the control group, with median overall survival time of 13.8 and 11.7 months, respectively (P>0.05). The most common adverse effect in the maintenance group included nausea, vomiting, leucocytopenia, and hand-foot syndrome; no death occurred in relation to the therapy. Conclusions S-1 maintenance chemotherapy, with a tolerable toxicity profile, can improve the RR, DCR and median time to progression in AGC patients who respond to DCF regimen, but its efficacy still awaits further evaluation.