比较卡培他滨与替吉奥(S-1)分别联合奥沙利铂(L-OHP)治疗进展期胃癌的有效性和安全性.方法 94例进展期胃癌患者分为两组,A组(XELOX方案)54例,具体为:L-OHP 130 mg/m2静滴2h,d1；卡培他滨1000 mg/m2 bid,d1～d14,3周为1周期；B组(L-OHP+ S-1 )40例,具体为:L-OHP 130 mg/m2静滴2h,d1；S-1 40 mg/m2分早晚2次餐后服用,d1～d14,3周为1周期.2个周期评价疗效及毒性.治疗前后分别进行血常规、肝肾功能、胸腹部CT扫描及胃镜等检查,观察肿瘤病灶大小变化,记录临床症状变化和化疗毒副反应,随访两组的疾病进展时间和生存期.结果 94例均可评价疗效,A、B两组的有效率分别为46.4％和51.8％,疾病控制率为72.8％和79.4％,中位疾病进展时间为6.6个月和6.8个月,中位生存时间为13.5个月和14.0个月,上述两组差异均无统计学意义(P＞0.05).两组毒副反应主要包括血液学毒性、肝肾功能异常、恶心呕吐、腹泻、末梢神经毒性和手足综合征等,以1～2级为主,均可耐受.结论 卡培他滨联合L-OHP与S-1联合L-OHP治疗进展期胃癌的疗效相当,不良反应均可耐受.%Objective To evaluate the efficacy and toxicity of two different oral fluoropyrimidines capecitabine or S-l in combination with oxaliplatin ( L-OHP) in patients with advanced gastric. Methods Ninety-four advanced gastric patients were divided into two groups; Group A(XELOX regimen) : 54 patients were treated with L-OHP 130mg/m2 d, and capecitabine 1000mg/m2 bid d1-d14. Three weeks was a cycle. Group B( L-OHP + S-l): 40 patients were treated with L-OHP 130 mg/m2 d, and S-l 40mg/m2 orally twice daily after meal d1-d14. Three weeks was a cycle. Blood routine, function of liver and kidney, chest and abdomen-CT or MRI, and gastroscopy were examined before and after treatment. The changes of cancer focus size, clinical symptoms, toxic and side effects were recorded and compared after 2 cycles. The time to progress and overall survival were observed. Results All patients were assessable for toxicity and response to treatment. In group A and group B, the remission rate were 46.4 % and 51. 8% , the disease control rate were 72. 8% and 79. 4 % , the median time to progress were 6. 6months and 6. 8 months, and the median overall survival were 13.5 months and 14.0 months. There was no significance between group A and group B( P > 0. 05). Side effects were similar in the two groups, mainly in bone marrow depression, nausea and vomiting, diahrrea, dysfunction of liver and kidney, and hand-foot syndrome. All these side effects were of stage 1-2, and well tolerated. Conclusion Capecitabine plus L-OHP and S-l plus L-OHP are active therapeutic equivalence and well tolerated in patients with advanced gastric cancer.
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