SOX方案一线化疗后替吉奥维持治疗晚期胃癌的临床观察Clinical efficacy of S-1 maintenance chemotherapy after first-line SOX regimen in the treatment of advanced gastric cancer
黎超
摘要(Abstract):
目的评价替吉奥维持化疗在SOX方案(替吉奥+奥沙利铂)一线化疗后评估疾病无进展的晚期胃癌患者中的疗效及安全性。方法 67例晚期胃癌患者在接受SOX方案一线化疗6个周期后疗效评估疾病无进展。据患方意愿接受观察29例(观察组),接受替吉奥维持化疗38例(维持组)。维持化疗方案为:替吉奥40~60 mg口服2次/d,d1-21,每5周为1个周期,均每2个周期按照RECIST 1.1评价近期疗效,采用NCI-CTCAE 4.0评价化疗不良反应。观察组如无相关临床症状恶化则每2个月进行相关检查评估,并采用电话随访方式确定生存情况。结果观察组及维持组中位至肿瘤进展时间(time to progression,TTP)分别为8.2个月和9.8个月(P=0.026),中位生存时间(overall survival,OS)分别为14.6个月和17.4个月(P=0.019)。维持组常见不良反应主要为Ⅰ~Ⅱ度中性粒细胞减少、贫血、皮肤色素沉着、恶心、食欲不振和疲乏等,无化疗相关死亡事件发生。结论 SOX方案一线化疗6个周期后评估继续临床获益的晚期胃癌患者生存期较长,接受单药替吉奥维持化疗耐受性良好,一线化疗耐受性佳的患者更可能从维持化疗中获益。
关键词(KeyWords): 胃肿瘤/药物疗法;有机铂化合物/治疗应用;抗肿瘤联合化疗方案/治疗应用;氟尿嘧啶/治疗应用;氟尿嘧啶/类似物和衍生物;治疗结果
基金项目(Foundation):
作者(Author): 黎超
DOI: 10.13267/j.cnki.syzlzz.2017.06.008
参考文献(References):
- [1]Digklia A,Wagner AD.Advanced gastric cancer:Current treatment landscape and future perspectives[J].World J Gastroentero,2016,22(8):2403-2414.
- [2]王尧,徐农.晚期胃癌内科治疗问题与展望[J].实用肿瘤杂志,2015,30(5):404-408.
- [3]Yasui H,Fujii H,Yamaguchi K,et al.PhaseⅢstudy comparing oxaliplatin plus S-1 with cisplatin plus S-1 in chemotherapy-naive patients with advanced gastric cancer[J].Ann Oncol,2015,26(1):141-148.
- [4]童流妹,徐惠亮,蒋红良.SOX方案及XELOX方案一线治疗晚期胃癌的临床研究[J].实用肿瘤杂志,2015,30(1):56-59.
- [5]Perol M,Chouaid C,Perol D,et al.Randomized,phaseⅢstudy of gemcitabine or erlotinib maintenance therapy versus observation,with predefined second-line treatment,after cisplatin-gemcitabine induction chemotherapy in advanced non-small-cell lung cancer[J].J Clin Oncol,2012,30(28):3516-3524.
- [6]Athanasiadis C,Stratis IG.OPTIMOX1:A randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-go fashion in advanced colorectal cancer-A GERCOR study[J].J Clin Oncol,2006,24(3):394-400.
- [7]Eisenhauer EA,Therasse P,Boqaerts J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
- [8]US Department of Health and Human Services&National Institutes of Health&National Cancer Institue.Common terminology criteria for adverse events(CTCAE)version4.0 published:May 28,2009(v4.03:June 14,2010)[EB/OL].[2010-06-14](2017-08-05).http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf
- [9]Schoffski P.The modulated oral fluoropyrimidine prodrug S-1,and its use in gastrointestinal cancer and other solid tumors[J].Anticancer Drugs,2004,15(2):85-106.
- [10]Waddell T,Chau I,Cunningham D,et al.Epirubicin,oxaliplatin,and capecitabine with or without panitumumab for patients with previously untreated advanced oesophagogastric cancer(REAL3):a randomised,open-label phase 3 trial[J].Lancet Oncol,2013,14(6):481-489.
- [11]周一,黄镜,杨林,等.奥沙利铂联合替吉奥在胃癌术后辅助化疗中的安全性分析[J].中华肿瘤杂志,2012,34(11):860-864.
- [12]孙婷,李平,张梅,等.晚期胃癌维持治疗现状[J].吉林中医药,2014,34(10):1077-1080.
- [13]王树滨,吴煊,陈晓秋,等.卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗的临床观察[J].中国肿瘤临床,2016,43(20):913-917.
- [14]陈敬华,申维玺,夏俊贤,等.DCF方案一线化疗后替吉奥维持治疗晚期胃癌[J].南方医科大学学报,2014,34(7):1057-1060.
- [15]吴卿.卡培他滨或替吉奥维持治疗晚期胃癌的疗效及不良反应观察[D].福建医科大学:肿瘤学系,2014.
- [16]胡传朋,顾康生.ERCC1蛋白表达在晚期胃癌含铂一线及替吉奥维持治疗中的作用[J].安徽医科大学学报,2016,51(10):1504-1509.