放疗联合S1与单纯化疗治疗晚期胃癌的疗效比较.docVIP

放疗联合S-1与单纯化疗治疗晚期胃癌的疗效比较 王兵曹新桥刘志强周凤举 （哈励逊国际和平医院放疗科 河北 衡水053000） 摘 要 目的探讨放疗联合替吉奥（S?l）与5?FU、奥沙利钳单纯化疗 治疗方案对不能手术的初治晚期胃癌的疗效和毒副反应的比较。方法80例不 能手术的初治晚期胃癌随机分为两组。放疗联合S-1组，口服S-1 40 mg/m\ bid、 连续服4周、休息2周。同期给予以胃原发灶及转移灶三维适形放射治疗，常规 分割1.8 Gy /次。胃原发灶Dt45 Gy / 25次，腹主动脉旁转移淋巴结2 Gy/次, DT60 Gy / 30次。然后再行S-1化疗2周期。单纯化疗组（40例）FOL FOX4方案澳 沙利钳200 mg，静脉点滴1;亚叶酸钙0.2静脉点滴dl-5 ;氟尿卩密噪0.8-1.0,持续 静脉点滴,dl-5;21d为1周期）,全部患者接受3-4周期化疗。结果两组病例 均可评价疗效，总有效率分别为70%和61.1%,完全缓解率分别为25%和16.7%, 部分缓解率分别为45%和44.4%o肿瘤中位进展时间分别为116个月和8.3个月， 中位牛存期分别为16个月和13.9个月。放化疗组与单纯化疗组相比较，其腹主 动脉旁淋巴结完全缓解率据有统计学意义（chi;2=3.94P0.05）,而原发灶及其 它转移灶、以及主要毒副反应之间均无统计学意义。两组主要的毒副反应均为骨 髓功能抑制，无治疗相关性死亡。结论放疗联合S-1治疗组与单纯化疗组相比， 在局部控制率、肿瘤中位进展时间、中位生存期均具有一定的优势，其毒副反应 未增加，患者能够耐受，值得推荐。 关键词 胃肿瘤；替吉奥；奥沙利钳；放射治疗；化疗 1R735.2 ］A 11003-5028（2015 ） 5-0184-02 The curative effect compare of regimen between simply chemotherapy and radio-Sl for advanced gastric cancer WANG Bing, CAO Xin-qiaoz LIU Zhi-qiang * , ZHOU Feng-ju. * Department of radiotherapy, Harris on inter natio nal Hepi ng Hospital, Henshui 053000, China) Corresponding author: LIU Zhi-qiang, : ［Abstract ］ Objective: To compare the curative effect and subsidiary response of regimen between simply chemotherapy and radio-Sl for advaneed gastric cancer. Methods These 44 advanced gastric cancer patients was divided in two groups. The radio-Sl group patients accepted radiotherapy. The gastric original range region was given 4500 cGy in 25 fractions. The metastasis region were given 6000 cGy in 30 fractions. At the same time,they were given S-l,40mg bid.After radiotherapy they accepted 2 cycles S-l again. The chemotherapy methods was 5-fu on the dl-5 and oxalibplatin on the same day. Every cycle was 21 days. Every group was given 3 cycles at least. Results The overall response rate of borh groups was respectively 70% and 61.1%, complete response rate was 25% and 16.7%, patial response rate was 45% and 44.4%. The time to progress! on (TTP) was 11.6m on ths and 8.3m on ths, and mea n survival time (MST) was 16.0m on t