目的 观察替吉奥胶囊(S-1)单药用于老年胃癌患者术后辅助化疗的疗效及不良反应.方法 52例D2根治术后老年胃癌患者随机分为:治疗组(n=26)应用S-1单药辅助化疗(S-1 40-60mg口服,每天2次,d1～d28,6周为1周期),对照组(n=26)给予FOLFOX 4方案辅助化疗(奥沙利铂85mg/m2静滴,d1；亚叶酸钙200mg/m2静滴2h,d1～d2；氟尿嘧啶400mg/m2静滴,d1～d2；后续氟尿嘧啶600mg/m2持续静脉泵入22h,d1～d2,14天为1周期).观察两组患者的1年、2年生存率及无复发生存率和不良反应情况.结果 两组患者均完成6个月的辅助化疗,治疗组与对照组的1年生存率分别为69.23％和61.54％ (P ＞0.05),1年无复发生存率分别为53.85％和57.69％ (P ＞0.05)；治疗组与对照组的2年生存率分别为34.62％和38.46％ (P ＞0.05),2年无复发生存率分别为30.77％和23.08％ (P ＞0.05).治疗组的恶心呕吐、腹泻等消化道反应及周围神经毒性的发生率较对照组明显降低(P＜0.05).结论 老年胃癌患者D2根治术后接受S-1单药辅助化疗的疗效不亚于FOLFOX 4方案联合化疗,毒副反应低,患者依从性好.%Objective To evaluate the efficacy and toxicity of S-1 for elderly patients with gastric cancer after radical surgery.Methods After D2 radical surgery,52 cases of elderly gastric cancer were divided into 2 groups randomly.Twenty-six cases were treated by S-1 (S-1 40-60mg po,twice a day,d1-d28,6 weeks was one cycle) as treatment group.The another 26 cases were treated by FOLFOX 4 (oxaliplatin 85mg/m2 iv,d1 ; calcium folinatc 200mg/m2,iv 2h,d1-d2 ; 5-FU 400 mg/m2 iv,d1-d2 ; 5-FU 600 mg/m2,civ 22h,d1-d2,14 days was one cycle)as control group.Curative effects and toxicities were compared between the two groups in the following 2 years.Results All 52 patients were received 6 months' adjuvant chemotherapy.The 1-year survival rates in treatment and control group was 69.23％ and 61.54％,respectively(P ＞0.05).The 1-year relapse-free survival rates in two groups was 53.85％ and 57.69％,respectively(P ＞0.05).The 2-year survival rates in treatment and control group was 34.62％ and 38.46％,respeetively(P ＞ 0.05).The 2-year relapse-free survival rates in two groups was 30.77％ and 23.08％,respectively (P ＞ 0.05).Incidence rates of nausea,emesis,diarrhea and PN toxicity were remarkably lower in treatment group than those in control group(P ＜ 0.05).Conclusion After D2 radical surgery,curative effects of S-1 is similar to FOLFOX 4 for elderly gastric cancer patients and S-1 has less toxicities.
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