洛铂腹腔灌注联合替吉奥治疗晚期胃癌合并腹水临床观察.docVIP

洛铂腹腔灌注联合替吉奥治疗晚期胃癌合并腹水临床观察 　　[摘要] 目的 观察洛铂腹腔灌注联合替吉奥治疗晚期胃癌合并腹水的疗效和安全性。 方法 依照入选标准，选择经病理学确诊的老年或体力状况较差的晚期胃癌伴腹水患者30例。治疗方案：经B超定位腹腔置管，尽量放尽腹水后，洛铂30 mg/m2腹腔灌注，第1天；替吉奥口服：体表面积（BSA）＜1.25 m2者，40 mg，2次/d；BSA 1.25～1.50 m2者， 50 mg，2次/d；BSA≥1.50 m2者，60 mg，2次/d，连服14 d。21 d为1个周期，2个周期后评价疗效，观察有效率、疾病控制率、生活质量改善情况及毒副反应。 结果 30例患者中完全缓解0例，部分缓解12例，稳定13例，进展5例，有效率为40.0％，疾病控制率为83.3％。12例患者经1～2周期化疗后腹水全部消失，8例患者腹水明显减少，10例无明显变化。主要毒副反应为骨髓抑制、胃肠道反应及疲乏，其中骨髓抑制以白细胞减少、血小板减少、贫血为主，胃肠道反应以恶心/呕吐、腹泻为主，大多为Ⅰ～Ⅱ级，Ⅲ级及以上白细胞减少、血小板减少分别占6.7％和3.3%，无严重肝、肾毒性及心脏毒性，无手足综合征，无腹膜反应，无治疗相关性死亡。 结论 洛铂腹腔灌注联合替吉奥治疗老年或体力状况较差的合并腹水的晚期胃癌效果较高，毒性作用较小，可明显改善患者的生活质量。 　　[关键词] 洛铂；腹腔灌注；替吉奥；胃癌；腹水 　　[中图分类号] R735.2[文献标识码] A[文章编号] 1674-4721（2014）05（b）-0092-04 　　 　　Clinical observatioin of lobaplatin intraperitoneal combined with gimeracil and oteracil potassium capsules in treatment of advanced gastric cancer with ascites 　　QI Jin ZHENG Yu-jun WANG Ming-ji 　　Department of Oncology,Dalian Municipal Friendship Hospital,Dalian 116001,China 　　[Abstract] Objective To observe the curative effect and safety of lobaplatin combined with gimeracil and oteracil potassium capsules for advanced gastric cancer with ascites.Methods Following inclusion criteria,30 cases of elderly or poor performance status patients with advanced gastric cancer with ascites who were confirmed by pathology were enrolled.And locationed by B-ultrasonic wave and given puncturing and inserting catheter,were given 30 mg/m2 lobaplatin intraperitoneal,the first day;gimeracil and oteracil potassium capsules taken orally,body surface area(BSA)＜1.25 m2, 40 mg,2 times a day;BSA 1.25-1.50 m2,50 mg,2 times a day;BSA≥1.50 m2,60 mg,2 times a day,for continuous taking 14 days.21 days for a cycle.The curative effect was evaluated after 2 cycles,the response rate (RR),disease control rate (DCR),quality of life improvement and side reaction was observed.Results Curative effects of 30 patients were evaluated.Complete remission (CR) was recorded in 0 patient,partial responses (PR) were 12 patients,no