CAJ | 학술논문

目的：观察紫杉醇脂质体联合替吉奥（ S-1）胶囊与XELOX两种方案治疗进展期胃癌术后的效果及安全性。方法采用随机数字表法，将2009年3月—2011年1月在南华大学附属第一医院肿瘤外科行D2淋巴结清扫术，并于该院肿瘤中心进行辅助化疗的55例进展期胃癌患者分为两组，其中A组（ n=29）采用紫杉醇脂质体+替吉奥方案，B组（n=26）采用XELOX方案（奥沙利铂+卡培他滨）。比较两组患者1年和3年的无复发生存期（RFS）率、总生存期（ OS）率及化疗不良反应情况（包括腹泻、肝功能损害、周围神经病变、手足综合征、白细胞下降、血小板下降、血红蛋白下降、中性粒细胞下降、恶心及呕吐）。结果两组患者的1年和3年RFS率、OS率间差异均无统计学意义（P﹥0.05）。两组患者化疗不良反应均以骨髓抑制和恶心呕吐为主。B组手足综合征发生的强度高于A组，差异有统计学意义（P﹤0.05）。两组其余的不良反应强度虽有不同但差异无统计学意义（P﹥0.05）。结论两种方案在进展期胃癌行D2术后辅助化疗的近期疗效相当，紫杉醇脂质体联合替吉奥方案耐受性较好，具有良好的应用前景。
목적：관찰자삼순지질체연합체길오（ S-1）효낭여XELOX량충방안치료진전기위암술후적효과급안전성。방법채용수궤수자표법，장2009년3월—2011년1월재남화대학부속제일의원종류외과행D2림파결청소술，병우해원종류중심진행보조화료적55례진전기위암환자분위량조，기중A조（ n=29）채용자삼순지질체+체길오방안，B조（n=26）채용XELOX방안（오사리박+잡배타빈）。비교량조환자1년화3년적무복발생존기（RFS）솔、총생존기（ OS）솔급화료불량반응정황（포괄복사、간공능손해、주위신경병변、수족종합정、백세포하강、혈소판하강、혈홍단백하강、중성립세포하강、악심급구토）。결과량조환자적1년화3년RFS솔、OS솔간차이균무통계학의의（P﹥0.05）。량조환자화료불량반응균이골수억제화악심구토위주。B조수족종합정발생적강도고우A조，차이유통계학의의（P﹤0.05）。량조기여적불량반응강도수유불동단차이무통계학의의（P﹥0.05）。결론량충방안재진전기위암행D2술후보조화료적근기료효상당，자삼순지질체연합체길오방안내수성교호，구유량호적응용전경。
Objective To observe the efficacy and safety of paclitaxel liposome combined with S-1 and the XELOX regimen as postoperative adjuvant chemotherapy for advanced gastric cancer. Methods A total of 55 gastric cancer patients undergoing D2 lymph node dissection and adjuvant chemotherapy in the Department of Oncological Surgery of the First Affiliated Hospital of University of South China from March 2009 to January 2011 were enrolled using random number table and were divided into group A(n=29)and group B(n=26). Group A was administered with paclitaxel liposome combined with S-1,and group B was administered with XELOX regimen ( oxaliplatin plus capecitabine ) . The 1 - year and 3 - year recurrence free survival(RFS),1-year and 3-year overall survival(OS),adverse reactions(including diarrhea,liver damage,peripheral neuropathy,hand-foot syndrome,nausea and vomiting,and decrease in WBC,PLT,Hb and Neutropenia) of the two groups were observed and compared. Results No significant differences were observed in 1 -year and 3 -year RFS and OS between group A and group B(P﹥0. 05). The primary adverse reactions were bone marrow suppression,nausea and vomiting for both groups. The incidence of hand-foot syndrome in group B was significantly higher than that in group A(P﹤0. 05). No statistical differences were found between the two groups in terms of other side effects(P﹥0. 05). Conclusion The paclitaxel liposome plus S-1 regimen shows a therapeutic effect similar to XELOX regimen on patients with advanced gastric cancer after D2 operation. The regimen of paclitaxel liposome plus S-1 is well tolerated and has a good application prospect.