FOLFOX6方案与DOF方案治疗晚期胃癌的临床疗效和安全性比较
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摘要
目的比较奥沙利铂+亚叶酸钙+氟尿嘧啶(FOLFOX6)方案和多西他赛+奥沙利铂+氟尿嘧啶(DOF)方案治疗晚期胃癌的临床疗效和安全性。方法回顾性分析93例Ⅲ～Ⅳ期胃癌患者的病历资料,依据治疗方案的不同将患者分为FOLFOX6组(n=48)和DOF组(n=45)。比较两组患者化疗2个周期后的临床疗效,评定不良反应发生情况。结果化疗2个周期后,DOF组患者的总有效率和疾病控制率分别为33.3%(15/45)和84.4%(38/45),分别高于FOLFOX6组的18.8%(9/48)和68.8%(33/48),差异均有统计学意义(P﹤0.05)。治疗过程中,DOF组患者的消化道不良反应较FOLFOX6组严重,差异有统计学意义(Z=-2.516,P﹤0.05);两组患者骨髓抑制和外周神经炎的发生情况比较,差异均无统计学意义(P﹥0.05)。结论与应用FOLFOX6方案治疗晚期胃癌相比,应用DOF方案的疗效更好,虽然消化道不良反应发生率较高,但患者均可耐受。
Objective To compare the efficacy and safety of oxaliplatin + leucovorin + fluorouracil(FOLFOX6) regimen and docetaxel + oxaliplatin + fluorouracil(DOF) regimen in the treatment of advanced gastric cancer. Method A total of 93 patients diagnosed with gastric cancer of stage Ⅲ-Ⅳ were included and retrospectively analyzed. These patients were grouped by respective chemotherapy regimens as FOLFOX6 group(n=48) and DOF group(n=45). After 2cycles of chemotherapy, the clinical efficacy was compared, and adverse reactions were evaluated. Result After 2 cycles of treatment, the overall response rate and disease control rate in DOF group were 33.3%(15/45) and 84.4%(38/45), and were higher than that in FOLFOX6 group at 18.8%(9/48) and 68.8%(33/48), respectively, with statistically significant differences observed(P<0.05). During treatment, the gastrointestinal adverse reactions was significantly more serious in the DOF group than in the FOLFOX6 group, the difference was statistically significant(Z=-2.516, P<0.05);the occurrence of myelosuppression and peripheral neuritis were similar between the two groups, showing no significant difference(P>0.05). Conclusion Compared with the application of FOLFOX6 regimen, DOF regimen is more efficacious in the treatment of advanced gastric cancer, though higher incidence of tolerable gastrointestinal adverse reactions is observed.
Objective To compare the efficacy and safety of oxaliplatin + leucovorin + fluorouracil(FOLFOX6) regimen and docetaxel + oxaliplatin + fluorouracil(DOF) regimen in the treatment of advanced gastric cancer. Method A total of 93 patients diagnosed with gastric cancer of stage Ⅲ-Ⅳ were included and retrospectively analyzed. These patients were grouped by respective chemotherapy regimens as FOLFOX6 group(n=48) and DOF group(n=45). After 2cycles of chemotherapy, the clinical efficacy was compared, and adverse reactions were evaluated. Result After 2 cycles of treatment, the overall response rate and disease control rate in DOF group were 33.3%(15/45) and 84.4%(38/45), and were higher than that in FOLFOX6 group at 18.8%(9/48) and 68.8%(33/48), respectively, with statistically significant differences observed(P<0.05). During treatment, the gastrointestinal adverse reactions was significantly more serious in the DOF group than in the FOLFOX6 group, the difference was statistically significant(Z=-2.516, P<0.05);the occurrence of myelosuppression and peripheral neuritis were similar between the two groups, showing no significant difference(P>0.05). Conclusion Compared with the application of FOLFOX6 regimen, DOF regimen is more efficacious in the treatment of advanced gastric cancer, though higher incidence of tolerable gastrointestinal adverse reactions is observed.
引文
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[12]李子禹,季加孚.胃癌的新辅助化疗[J].临床外科杂志,2010, 18(10):651-652.
[13] Li ZY, Koh CE, Bu ZD, et al. Neoadjuvant chemotherapy with FOLFOX:improved outcomes in Chinese patients with locally advanced gastric cancer[J]. J Surg Oncol,2012, 105(8):793-799.
[14] Ma J, Yao S, Li XS, et al. Neoadjuvant therapy of DOF regimen plus bevacizumab can increase surgical resection ratein locally advanced gastric cancer:a randomized, controlled study[J]. Medicine(Baltimore), 2015, 94(42):e1489.
[15] Liu M, Hu G, Wang Y, et al. Comparison of FOLFOX and DOF regimens as first-line treatment in East Asian patients with advanced gastric cancer[J]. Onco Targets Ther,2018, 11:375-381.
[2] Zhang G, Du H, Wang Z, et al. Progress in study on the treatment of gastric cancer with docetaxel[J]. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 2018, 43(2):216-221.
[3] Lan YQ, Kong LJ, Lin XY, et al. Combination chemotherapy with paclitaxel and oxaliplatin as first-line treatment in patients with advanced gastric cancer[J]. Cancer Chemother Pharmacol, 2018, 81(6):1007-1015.
[4] Petrioli R, Francini E, Roviello F, et al. Sequential treatment with epirubicin, oxaliplatin and 5FU(EOF)followed by docetaxel, oxaliplatin and 5FU(DOF)in patients with advanced gastric or gastroesophageal cancer:a single-institution experience[J]. Cancer Chemother Pharmacol, 2015,75(5):941-947.
[5] Jung YS, Koo DH, Yang JY, et al. Peri-tumor administration of 5-fluorouracil sol-gel using a hollow microneedle for treatment of gastric cancer[J]. Drug Deliv, 2018, 25(1):872-879.
[6]丁婕,戴旭,孟宪运,等.实体瘤疗效评价标准的研究进展[J].中国肿瘤临床与康复, 2015, 22(9):1150-1152.
[7]潘宏铭,徐农,耿宝琴.肿瘤内科诊治策略[M].上海:上海科学技术出版社, 2002:428-429.
[8] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
[9] Brandl A, Pachmayr E, Gül-Klein S, et al. Surgical treatment of peritoneal metastases of gastric cancer[J]. Chirurg,2018, 89(9):669-677.
[10] Kim HJ, Oh SC. Novel systemic therapies for advanced gastric cancer[J]. J Gastric Cancer, 2018, 18(1):1-19.
[11] Eom BW, Kim S, Kim JY, et al. Survival benefit of perioperative chemotherapy in patients with locally advanced gastric cancer:a propensity score matched analysis[J]. J Gastric Cancer, 2018, 18(1):69-81.
[12]李子禹,季加孚.胃癌的新辅助化疗[J].临床外科杂志,2010, 18(10):651-652.
[13] Li ZY, Koh CE, Bu ZD, et al. Neoadjuvant chemotherapy with FOLFOX:improved outcomes in Chinese patients with locally advanced gastric cancer[J]. J Surg Oncol,2012, 105(8):793-799.
[14] Ma J, Yao S, Li XS, et al. Neoadjuvant therapy of DOF regimen plus bevacizumab can increase surgical resection ratein locally advanced gastric cancer:a randomized, controlled study[J]. Medicine(Baltimore), 2015, 94(42):e1489.
[15] Liu M, Hu G, Wang Y, et al. Comparison of FOLFOX and DOF regimens as first-line treatment in East Asian patients with advanced gastric cancer[J]. Onco Targets Ther,2018, 11:375-381.