中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2013年
4期
226-230
,共5页
冯娟%靳海峰%王飙落%张筱茵%刘娜%梁树辉%韩霜%杨莉萍%吴开春
馮娟%靳海峰%王飆落%張篠茵%劉娜%樑樹輝%韓霜%楊莉萍%吳開春
풍연%근해봉%왕표락%장소인%류나%량수휘%한상%양리평%오개춘
胃肿瘤%有机铂化合物%抗肿瘤联合化学治疗方案%化学疗法,辅助%药物评价
胃腫瘤%有機鉑化閤物%抗腫瘤聯閤化學治療方案%化學療法,輔助%藥物評價
위종류%유궤박화합물%항종류연합화학치료방안%화학요법,보조%약물평개
Stomach neoplasms%Organoplatinum compounds%Antineoplastic combined chemotherapy protocols%Chemotherapy,adjuvant%Drug evaluation
目的 评价以奥沙利铂为基础的化学治疗方案对胃癌术后辅助化学治疗患者及老年患者的有效性和安全性.方法 分析2008年11月至2011年11月间接受以奥沙利铂为基础的术后辅助化学治疗的324例胃癌患者,其中97例为＞65岁的老年患者.接受FOLFOX4/6方案(奥沙利铂+5-氟尿嘧啶+亚叶酸钙)者112例,其中老年患者30例；接受EOX方案(奥沙利铂+表柔比星+卡培他滨)者86例,其中老年患者25例；接受XELOX方案(奥沙利铂+卡培他滨)者126例,其中老年患者42例.统计各组的总生存率和无病生存率,分析各化学治疗方案的有效性和安全性.采用卡方检验比较各组患者间的临床资料,采用寿命表法计算累计生存率.结果 324例患者中54例(其中老年患者14例)未完成全程化学治疗.270例完成了全程化学治疗及术后3年随访.中青年组187例患者中,EOX、FOLFOX6、FOLFOX4、XELOX方案的3年无病生存率分别为74.5％、75.5％、73.5％、72.0％,各方案差异无统计学意义(x2=0.016,P=0.899),其3年总生存率分别为77.0％、78.0％、76.0％、76.5％,各方案差异无统计学意义(x2=0.020,P=0.990).老年组83例患者中,EOX、FOLFOX4/6、XELOX方案的3年无病生存率分别为73.0％、75.5％、75.0％,各方案差异无统计学意义(x2=0.017,P=0.894),3年总生存率分别为76.0％、79.0％、78.0％,各方案差异无统计学意义(x2=0.028,P=0.915).其中高分化组患者的3年总生存率为76.0％、无病生存率为73.0％,中分化组3年总生存率为74.0％、无病生存率为72.0％,低分化组3年总生存率为75.0％、无病生存率为73.0％.中青年组生存期达36个月者141例,老年组生存期达36个月者61例,两组生存期差异无统计学意义(U=1.72,P＞0.05).主要不良反应包括白细胞和(或)中性粒细胞减少、血小板减少、贫血,恶心、呕吐、腹泻、肝功能异常,周围神经毒性.结论 以奥沙利铂为基础的3种标准方案均能显著延长患者的生存期,不良反应发生率低,安全有效,老年患者耐受性、安全性、依从性亦较好.
目的 評價以奧沙利鉑為基礎的化學治療方案對胃癌術後輔助化學治療患者及老年患者的有效性和安全性.方法 分析2008年11月至2011年11月間接受以奧沙利鉑為基礎的術後輔助化學治療的324例胃癌患者,其中97例為＞65歲的老年患者.接受FOLFOX4/6方案(奧沙利鉑+5-氟尿嘧啶+亞葉痠鈣)者112例,其中老年患者30例；接受EOX方案(奧沙利鉑+錶柔比星+卡培他濱)者86例,其中老年患者25例；接受XELOX方案(奧沙利鉑+卡培他濱)者126例,其中老年患者42例.統計各組的總生存率和無病生存率,分析各化學治療方案的有效性和安全性.採用卡方檢驗比較各組患者間的臨床資料,採用壽命錶法計算纍計生存率.結果 324例患者中54例(其中老年患者14例)未完成全程化學治療.270例完成瞭全程化學治療及術後3年隨訪.中青年組187例患者中,EOX、FOLFOX6、FOLFOX4、XELOX方案的3年無病生存率分彆為74.5％、75.5％、73.5％、72.0％,各方案差異無統計學意義(x2=0.016,P=0.899),其3年總生存率分彆為77.0％、78.0％、76.0％、76.5％,各方案差異無統計學意義(x2=0.020,P=0.990).老年組83例患者中,EOX、FOLFOX4/6、XELOX方案的3年無病生存率分彆為73.0％、75.5％、75.0％,各方案差異無統計學意義(x2=0.017,P=0.894),3年總生存率分彆為76.0％、79.0％、78.0％,各方案差異無統計學意義(x2=0.028,P=0.915).其中高分化組患者的3年總生存率為76.0％、無病生存率為73.0％,中分化組3年總生存率為74.0％、無病生存率為72.0％,低分化組3年總生存率為75.0％、無病生存率為73.0％.中青年組生存期達36箇月者141例,老年組生存期達36箇月者61例,兩組生存期差異無統計學意義(U=1.72,P＞0.05).主要不良反應包括白細胞和(或)中性粒細胞減少、血小闆減少、貧血,噁心、嘔吐、腹瀉、肝功能異常,週圍神經毒性.結論 以奧沙利鉑為基礎的3種標準方案均能顯著延長患者的生存期,不良反應髮生率低,安全有效,老年患者耐受性、安全性、依從性亦較好.
목적 평개이오사리박위기출적화학치료방안대위암술후보조화학치료환자급노년환자적유효성화안전성.방법 분석2008년11월지2011년11월간접수이오사리박위기출적술후보조화학치료적324례위암환자,기중97례위＞65세적노년환자.접수FOLFOX4/6방안(오사리박+5-불뇨밀정+아협산개)자112례,기중노년환자30례；접수EOX방안(오사리박+표유비성+잡배타빈)자86례,기중노년환자25례；접수XELOX방안(오사리박+잡배타빈)자126례,기중노년환자42례.통계각조적총생존솔화무병생존솔,분석각화학치료방안적유효성화안전성.채용잡방검험비교각조환자간적림상자료,채용수명표법계산루계생존솔.결과 324례환자중54례(기중노년환자14례)미완성전정화학치료.270례완성료전정화학치료급술후3년수방.중청년조187례환자중,EOX、FOLFOX6、FOLFOX4、XELOX방안적3년무병생존솔분별위74.5％、75.5％、73.5％、72.0％,각방안차이무통계학의의(x2=0.016,P=0.899),기3년총생존솔분별위77.0％、78.0％、76.0％、76.5％,각방안차이무통계학의의(x2=0.020,P=0.990).노년조83례환자중,EOX、FOLFOX4/6、XELOX방안적3년무병생존솔분별위73.0％、75.5％、75.0％,각방안차이무통계학의의(x2=0.017,P=0.894),3년총생존솔분별위76.0％、79.0％、78.0％,각방안차이무통계학의의(x2=0.028,P=0.915).기중고분화조환자적3년총생존솔위76.0％、무병생존솔위73.0％,중분화조3년총생존솔위74.0％、무병생존솔위72.0％,저분화조3년총생존솔위75.0％、무병생존솔위73.0％.중청년조생존기체36개월자141례,노년조생존기체36개월자61례,량조생존기차이무통계학의의(U=1.72,P＞0.05).주요불량반응포괄백세포화(혹)중성립세포감소、혈소판감소、빈혈,악심、구토、복사、간공능이상,주위신경독성.결론 이오사리박위기출적3충표준방안균능현저연장환자적생존기,불량반응발생솔저,안전유효,노년환자내수성、안전성、의종성역교호.
Objective To evaluate the efficacy and safety of oxaliplatin (OXA)-based chemotherapy as postoperative adjuvant chemotherapy for patients with gastric cancer and the aged patients.Methods From November 2008 to November 2011,324 gastric cancer patients received OXA based postoperative adjuvant chemotherapy were analyzed.Among them,97 patients were over 65 years old.A total of 112 patients accepted FOLFOX4/6 program (OXA + 5-fluorouracil + calicium folinate),among them 30 cases were aged patients.A total of 86 patients accepted EOX program (OXA + epirubicin + capecitabine),and 25 cases of them were aged patients.A total of 126patients accepted XELOX program (OXA + capecitabine),and 42 cases of them were aged patients.The overall survival (OS) and disease-free survival (DFS) of each group were counted.The efficacy and safety of each chemotherapy program were analyzed.Chi square test was performed to compare the clinical data of each group.Life table method was used to calculate the cumulative survival rate.Results Fifty-four cases (14 aged patients included) of 324 patients did not complete the full chemotherapy.A total of 270 cases completed the full chemotherapy and 3-year follow-up.In 187 young and middle-aged cases,the 3-year DFS rate of EOX,FOLFOX6,FOLFOX4 and XELOX programs was 74.5％,75.5％,73.5％ and 72.0％ respectively,and there was no statistically significant difference between groups (x2=0.016,P=0.899).The 3-year OS rate was 77.0％,78.0％,76.0％ and 76.5％ respectively,there was no statistically significant difference between groups (x2=0.020,P=0.990).In 83 aged patients,the 3-year DFS rate of EOX,FOLFOX4/6 and XELOX programs was 73.0％,75.5％ and 75.0％ respectively,there was no statistically significant difference between groups (x2 =0.017,P=0.894),3-year OS rate was 76.0％,79.0％ and 78.0％ respectively,there was no statistically significant differences between groups (x2=0.028,P=0.915).The 3-year OS and DFS of high differentiation group was 76 ％ and 73 ％,middle differentiation group was 74％ and 72％,and low differentiation group was 75％ and 73％.There were 141 cases in young and middle-aged group with 36 months survival period,while 61 cases in aged group,and there was no significant difference in survival period between two groups (U=1.72,P＞0.05).The main side effects included leukopenia,neutropenia,thrombocytopenia,anemia,nausea,vomiting,peripheral neurotoxicity,diarrhea and abnormal liver function injury.Conclusions All the three OXA-based standard programs could significantly prolong the survival period of patients with low rates of side-effects.They were identified to have good tolerance,high safety and high compliance even in aged patients.
