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1、·药物与临床·中国当代医药2014年5月第21卷第14期洛铂腹腔灌注联合替吉奥治疗晚期胃癌合并腹水的临床观察齐瑾郑玉军王明吉大连市友谊医院肿瘤科,大连116001[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30mg/m2腹腔灌注,第1天;替吉奥口服:体表面积(BSA)<1.25m2者,40mg,2次/d;BSA1.25~1.50m2者,50mg,2次/d;BSA≥
2、1.50m2者,60mg,2次/d,连服14d。21d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%
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)-0092-04Clinicalobservatioinoflobaplatinintraperitonealcombinedwithgimeracilandoteracilpotassiumcap
4、sulesintreatmentofadvancedgastriccancerwithascitesQIJinZHENGYu-junWANGMing-jiDepartmentofOncology,DalianMunicipalFriendshipHospital,Dalian116001,China[Abstract]ObjectiveToobservethecurativeeffectandsafetyoflobaplatincombinedwithgimeracilandoteracilpotassiumcapsule
5、sforadvancedgastriccancerwithascites.MethodsFollowinginclusioncriteria,30casesofelderlyorpoorperformancestatuspatientswithadvancedgastriccancerwithasciteswhowereconfirmedbypathologywereen-2rolled.AndlocationedbyB-ultrasonicwaveandgivenpuncturingandinsertingcathete
6、r,weregiven30mg/mlobaplatin2intraperitoneal,thefirstday;gimeracilandoteracilpotassiumcapsulestakenorally,bodysurfacearea(BSA)<1.25m,2240mg,2timesaday;BSA1.25-1.50m,50mg,2timesaday;BSA≥1.50m,60mg,2timesaday,forcontinuoustaking14days.21daysforacycle.Thecurativeeffec
7、twasevaluatedafter2cycles,theresponserate(RR),diseasecontrolrate(DCR),qualityoflifeimprovementandsidereactionwasobserved.ResultsCurativeeffectsof30patientswereevaluat-ed.Completeremission(CR)wasrecordedin0patient,partialresponses(PR)were12patients,norelieve(NR)wer
8、e13patients,progressionofdiseasewere5patients.TheRRwas40.0%,DCRwas83.3%.Ascitesof12patientswerecom-pletelydisappearedand8patientswereobviouslyreducedand