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    整合化疗治疗老年局部晚期胃癌的临床研究

    Clinical study of integrated chemotherapy in the treatment of locally advanced gastric cancer in the elderly

      摘要
    • 摘要:
      目的研究整合化疗在老年局部晚期胃癌治疗中的作用。
      方法选取老年局部晚期胃癌60例，随机分为观察组和对照组，各30例。观察组采用介入治疗+口服替吉奥，介入灌注药物为氟尿嘧啶1.0 g/m2+奥沙利铂130 mg/m2，术后一周口服替吉奥40毫克/次，一日2次，连服4周，休息2周，为一周期，两周期评估治疗情况。对照组采用口服替吉奥，剂量及疗程同观察组，静脉应用奥沙利铂150 mg/m2。比较2组病人近期疗效、不良反应和预后情况。
      结果观察组客观反应率、疾病控制率分别为50.0%、83.3%，对照组分别为26.6%、50.0%，2组病人治疗效果差异有统计学意义（P < 0.01）。2组病人不良反应多为轻-中度反应，对症处理后均缓解，差异无统计学意义（P>0.05）。观察组中位无进展生存期为17个月，95%CI：16.53~25.28，对照组中位无进展生存期13个月，95%CI：10.98~14.18，观察组生存期较对照组明显延长（P < 0.01）。单因素分析显示病人生存情况与肿瘤位置、病期、是否手术、化疗后情况等因素有关（P < 0.05~P < 0.01），与病人性别、病理类型、大体类型等无明显相关性（P>0.05）。多因素分析显示分组情况是预后的独立影响因素（P < 0.01，95%CI=19.89~21.54）。
      结论应用整合化疗治疗老年局部晚期胃癌能改善病人预后，安全性较好。

       

      Abstract:
      ObjectiveTo explore the integrated chemotherapy in the treatment of locally advanced gastric cancer in the elderly.
      MethodsSixty elderly cases with locally advanced gastric cancer were randomly divided into observation group and control group (30 cases in each group).The observation group was treated with interventional therapy of 5-fluorouracil 1.0 g/m2 plus oxaliplatin 130 mg/m2, and oral tegiol 40 mg each time at one week after surgery, bid, for 4 weeks, rest for 2 weeks, which was a cycle.The treatment efficacy was evaluated after two cycles.The control group was treated with oral tegiol following the same dose and course of treatment as the observation group, and oxaliplatin 150 mg/m2 was used intravenously.The short-term efficacy, adverse reactions and prognosis in two groups were compared.
      ResultsThe objective response rate and disease control rate in observation group were 50.0% and 83.3%, respectively, which were 26.6% and 50.0% in control group, respectively.There was a significant difference in treatment efficacy between two groups (P < 0.01).The adverse reactions in two groups were mostly mild to moderate, and were alleviated after symptomatic treatment, the difference of which was not statistically significant (P>0.05).The median progression-free survival was 17 months, with 95%CI of 16.53 to 25.28 in observation group, which were 13 months and 10.98 to 14.18 in control group, and the survival time in observation group was significantly longer than that in control group (P < 0.01).Univariate analysis showed that the survival time of patients was correlated with the location of tumor, duration of disease, surgery or not, and postchemotherapy (P < 0.05 to P < 0.01), and was not significantly correlated with the gender, pathological type and gross type (P>0.05).Multivariate analysis showed that grouping was an independent prognostic factor (P < 0.01, 95%CI=19.89-21.54).
      ConclusionsThe application of integrated chemotherapy in treating locally advanced gastric cancer in elderly patients can improve the prognosis with good safety.

       

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