SOX与EOS方案治疗老年晚期胃癌的比较研究

侯杰1 ，刘阳2

（宝鸡市中心医院：1.肿瘤内科；2.妇科，陕西 宝鸡，721008）

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摘要：

目的 比较两药方案SOX（奥沙利铂+替吉奥）与三药方案EOS（表柔比星+奥沙利铂+替吉奥）治疗体力状况好的老年晚期胃癌的疗效及副作用。方法 选择PS评分为0~1 分的老年晚期胃癌患者50 例，根据化疗方案不同分为SOX组（奥沙利铂+替吉奥）和EOS组（表柔比星+奥沙利铂+替吉奥）。SOX组（26例）给予奥沙利铂130 mg/m²，静滴3 h，d1；替吉奥40mg/m²，口服，2 次/d，d1～d14；EOS组（24例）给予表柔比星40mg/m²，静注，d1；奥沙利铂100mg/m²，静滴3 h，d1；替吉奥30 mg/m²， 口服，2 次/d，d1～d14；两组均以21 d 为1周期，治疗2周期后，比较两组患者的临床效果及副作用。结果 SOX组患者完成化疗周期数明显多于EOS组，差异具有统计学意义（t=5.1287，P<0.0001）。SOX组和EOS组的有效率（57.69% vs. 25.00%）、中位PFS（5.00 月vs. 4.00 月）比较，SOX 组高于EOS 组（P<0.05）。两组副作用均表现为白细胞减少、血小板减少、贫血、恶心呕吐、腹泻、周围神经毒性、脱发。SOX组和EOS组的白细胞减少（50.00% vs. 70.83%）、血小板减少（38.46% vs. 62.50%）、恶心 呕吐（46.15% vs. 87.50%）、脱发（0.00% vs. 83.33%）发生率比较，SOX组明显低于EOS组（P<0.05）；SOX组周围神经毒性发 生率为53.85%，明显高于EOS 组的16.67%（P<0.05），均为Ⅰ~Ⅱ度；SOX组和EOS组贫血（34.62% vs. 54.17%）、腹泻（7.69% vs. 4.17%）发生率比较，差异无统计学意义（P>0.05），均为Ⅰ~Ⅱ度。结论 对于老年晚期胃癌患者，两药方案SOX的优于三药方案EOS，即使这些患者均为体力状况好的老年患者。

关键词：晚期胃癌；替吉奥；奥沙利铂；表柔比星

中图分类号：R735.2文献标志码：A文章编号：2096-1413(2017)18-0004-03

Comparative study between SOX regimen and EOS regimen in elderly patients with advanced gastric cancer
HOU Jie 1, LIU Yang 2
(1. Department of Medical Oncology; 2. Department of Gynaecology, Baoji Central Hospital, Baoji 721008, China)

ABSTRACT: Objective To evaluate the efficacy and adverse effects of SOX (oxaliplatin+S-1) vs. EOS (epirubicin+oxaliplatin +S -1) in elderly patients of good physical performance with advanced gastric cancer. Methods Fifty elderly patients of performance score 0-1 with advanced gastric cancer were selected and divided into SOX group (oxaliplatin+S-1) and EOS group (epirubicin+oxaliplatin+S-1) according to different chemotherapy regimens. The SOX group (26 cases) was given oxaliplatin 130 mg/m2 ivgtt 3 h, d1; S-1 40 mg/m2, p.o., bid, d1-14; the EOS group (24 cases) was given epirubicin 40 mg/m2 ivgtt, d1; oxaliplatin 100 mg/m2 ivgtt 3 h, d1; S-1 30 mg/m2, p.o., bid, d1-d14; 21 days per cycle, the clinical efficacy and adverse effects of the two groups were evaluated after 2 cycles. Results The cycles of chemotherapy of the SOX group were more than those of the EOS group (t =5.1287, P<0.0001). In the SOX and EOS group, there were statistically significant differences in response rate (RR) (57.69% vs. 25.00%) and the median progression free survival (5.00 months vs. 4.00 months), those in the SOX group were higher than the EOS group (P <0.05). Leukopenia, thrombocytopenia, aneamia, nausea and vomiting, diarrhea, peripheral nerve toxicity and alopecia were all the adverse effects observed in both groups. In SOX and EOS group, there were statistically significant differences in the incidences of leukopenia (50.00% vs. 70.83%), thrombocytopenia (38.46% vs. 62.50%), nausea and vomiting (46.15% vs. 87.50%), alopecia (0.00% vs. 83.33%), and those in the SOX group were significantly lower than the EOS group (P<0.05). The incidence of peripheral nerve toxicity in the SOX group was 53.85%, which was significantly higher than 16.67% in the EOS group (P<0.05), and they were all gradeⅠ~Ⅱ. In the SOX and EOS group, there were no statistically significant differences in the incidences of aneamia (34.62% vs. 54.17%) and diarrhea (7.69% vs. 4.17%) (P>0.05), and they were all gradeⅠ~Ⅱ. Conclusion For elderly patients with advanced gastric cancer, the two drugs chemotherapy regimen SOX is better than the three drugs chemotherapy regimen EOS, although for the elderly patients with good physical performance.

KEYWORDS: advanced gastric cancer; S-1; oxaliplatin; epirubicin

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