• 四川省南充市中心醫(yī)院腫瘤科,四川南充 637000;

摘要:目的:評價塞來昔布(Celecoxib)聯合希羅達(Xeloda)節(jié)拍化療(metronomic chemotherapy)治療老年晚期胃癌的客觀療效及毒副反應,探討老年晚期胃癌高緩解率、低毒性的治療方法。方法:45例患者隨機分為兩組。治療組23例,采用塞來昔布與希羅達節(jié)拍化療, Celecoxib 200 mg Bid, Xeloda 500 mg Bid,連續(xù)服藥,直至病情進展。4周為一周期,至少1周期后評定療效。對照組22例,采用FOLFOX4方案化療:LOHP 85 mg/m2 iv gtt 2h d1,CF 200 mg/m2 iv gtt 2h d1、d2,5FU 400 mg/m2 iv bolus d1、d2,5FU 600 mg/m2 civ 22h d1、d2。每2周重復,4周為1周期,至少1周期后評定療效。結果: 45例患者均獲得隨訪。治療組與對照組總有效率(RR)、疾病控制率(DCR)、生活質量改善率(QOL)分別為47.8%(11/23)、50.0%(11/22);91.3%(21/23)、63.6%(14/22);826%(19/23)、54.5%(12 /22)。 兩組患者中位疾病進展時間(mTTP)、中位生存期(MST)分別為9.5個月、5.5個月;13.5個月、9個月。治療組與對照組1年生存率分別為56.5％(13/23)、27.3％(6/22)。兩組總有效率差異無統(tǒng)計學意(P gt;0.05),生活質量改善率、疾病控制率、1年生存率差異有統(tǒng)計學意義(P lt;0.05)。治療組毒副反應輕微。結論:塞來昔布聯合希羅達節(jié)拍化療治療老年晚期胃癌安全、有效,患者得到生存受益,依從性好,效價比高,值得臨床進一步研究。

引用本文： 付曦,李光明,任大成,文世民,羅健. 塞來昔布/希羅達節(jié)拍化療治療老年晚期胃癌的臨床研究. 華西醫(yī)學, 2009, 24(8): 2027-2030. doi: 復制

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  3. 3. 江波,趙金奇,劉坤,等. FOLFOX4方案和ECF方案治療晚期胃癌的比較[J].臨床腫瘤學雜志,2008,13(1):43-45.
  4. 4. KERBEL R S. Tumor angiogenesis:past,present and the near future[J].Carcinogenesis,2000,21:505-515.
  5. 5. HARLOZINSKA A. Progress in molecular mechanisms of tumor metastasis and angiogenesis[J].Anticancer Res, 2005;25:332-3333.
  6. 6. BROWDER T, BUTTERFIELD C E, KRALING B M, et al. Antiangiogenic scheduling of chemotherapy improves efficacy against experimental drugresistant cancer[J]. Cancer Res,2000,60:1878-1886.
  7. 7. KERBEL R S, KLEMENT G, PRITCHARD K L, et al. Continuous lowdose antiangiogenic/metronomic chemotherapy:from the research laboratory into the oncology clinic[J].Ann Oncol,2002,13(1):12-15.
  8. 8. SAUKKONEN K, TOMASETTO C, NARKO K, et al. Cyclooxygenase2 expression and effect of celecoxib in gastric adenomas of trefoil factor 1deficient mice[J].Cancer Res,2003,63(10):3032-3036.