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mFOLFOX6和FOLFIRI方案分别一线和二线治疗晚期胃癌疗效对比观察

Comparison of Clinical Effect Between mFOLFOX6 and FOLFIRI Regimen as Alternately First-and Second-line Therapy on Advanced Gastric Cancer Patients

  • 摘要:
    目的  观察mFOLFOX6和FOLFIRI方案分别一线和二线方案治疗晚期胃癌的疗效及不良反应。
    方法  将62例晚期胃癌患者分为二组,对照组32例患者,一线采用mFOLFOX6方案治疗,疾病进展后,有25例患者二线采用FOLFIRI方案;观察组30例患者,一线采用FOLFIRI方案治疗,疾病进展后,有25例患者二线采用mFOLFOX6方案。对两组的疗效和不良反应做对比观察。
    结果  对照组和观察组一线、二线治疗晚期胃癌ORR分别为37.5%、24.0%和40.0%、16.0%,差异均无统计学意义(P=0.801, P=0.662),中位无疾病进展时间分别为(5.0±0.25)月、(2.0±0.36)月和(6.0±0.81)月、(2.0±0.27)月,差异均无统计学意义(P=0.178, P=0.803)。二组OS无明显差别,分别为(10.0±1.06)月和(11.0±1.17)月(P=0.500)。两组不良反应以骨髓抑制、胃肠道、周围神经炎为主。其中一线治疗过程中,对照组外周神经炎发生率比观察组高,而观察组的腹泻发生率高于对照组。
    结论  mFOLFOX6和FOLFIRI方案分别一线和二线治疗晚期胃癌患者疗效相当,均可延长患者生存,不良反应可以耐受。

     

    Abstract:
    Objective To observe and compare the efficacy and adverse reactions between mFOLFOX6 and FOLFIRI regimen as alternately first-and second-line chemotherapy on the patients with advanced gastric cancer(AGC).
    Methods A total of 62 AGC patients were divided into two groups: Control group, n=32, mFOLFOX6 regimen as the first-line treatment, FOLFIRI regimen as the second-line treatment on 25 patients after disease progression; Observation group, n=30, FOLFIRI regimen as the first-line therapy, mFOLFOX6 regimen as the second-line treatment on 25 patients after disease progression. The efficacy and adverse effects were evaluated.
    Results The overall response rates of first-, second-line therapy between control group and observation group were 37.5%, 24.0% and 40.0%, 16.0%, respectively(P=0.801, P=0.662); the median progression-free survival were (5.0±0.25), (2.0±0.36) and (6.0±0.81), (2.0±0.27) months, respectively, with no statistically significant difference (P=0.178, P=0.803); the median overall survival were (10.0±1.06) and (11.0±1.17) months in two groups(P=0.500). The most common toxicities in both groups were myelosuppression, gastrointestinal tract reaction and neurotoxicity. Control group had much higher neurotoxicity than observation group, nevertheless, the rate of diarrhea in observation group was higher than that in control group in first-line treatment.
    Conclusion mFOLFOX6 and FOLFIRI regimen have equal effect as alternately first-and second-line treatment on AGC patients, and both can prolong survival with low toxicity.

     

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