The Clinical Study of Celecoxib Combined with Xeloda Metronomic Chemotherapy in the Treatment of the Elderly with Advanced Gastric Cancer_West China Medical Journal

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Department of Oncology, the Centre Hospital of Nanchong City, Nanchong Sichuan637000,China;

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Keywords：

晚期胃癌; 节拍化疗; 塞来昔布; 希罗达; 老年人

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摘要:目的:评价塞来昔布(Celecoxib)联合希罗达(Xeloda)节拍化疗(metronomic chemotherapy)治疗老年晚期胃癌的客观疗效及毒副反应,探讨老年晚期胃癌高缓解率、低毒性的治疗方法。方法:45例患者随机分为两组。治疗组23例,采用塞来昔布与希罗达节拍化疗, Celecoxib 200 mg Bid, Xeloda 500 mg Bid,连续服药,直至病情进展。4周为一周期,至少1周期后评定疗效。对照组22例,采用FOLFOX4方案化疗: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周重复,4周为1周期,至少1周期后评定疗效。结果: 45例患者均获得随访。治疗组与对照组总有效率(RR)、疾病控制率(DCR)、生活质量改善率(QOL)分别为47.8%(11/23)、50.0%(11/22);91.3%(21/23)、63.6%(14/22);826%(19/23)、54.5%(12 /22)。两组患者中位疾病进展时间(mTTP)、中位生存期(MST)分别为9.5个月、5.5个月;13.5个月、9个月。治疗组与对照组1年生存率分别为56.5％(13/23)、27.3％(6/22)。两组总有效率差异无统计学意(P gt;0.05),生活质量改善率、疾病控制率、1年生存率差异有统计学意义(P lt;0.05)。治疗组毒副反应轻微。结论:塞来昔布联合希罗达节拍化疗治疗老年晚期胃癌安全、有效,患者得到生存受益,依从性好,效价比高,值得临床进一步研究。

Citation： FU Xi,LI Guangming,REN Dacheng,et al. The Clinical Study of Celecoxib Combined with Xeloda Metronomic Chemotherapy in the Treatment of the Elderly with Advanced Gastric Cancer. West China Medical Journal, 2009, 24(8): 2027-2030. doi: Copy

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3. 江波,赵金奇,刘坤,等. FOLFOX4方案和ECF方案治疗晚期胃癌的比较[J].临床肿瘤学杂志,2008,13(1):43-45.
4. KERBEL R S. Tumor angiogenesis:past,present and the near future[J].Carcinogenesis,2000,21:505-515.
5. HARLOZINSKA A. Progress in molecular mechanisms of tumor metastasis and angiogenesis[J].Anticancer Res, 2005;25:332-3333.
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. 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. 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.

West China Medical Journal

The Clinical Study of Celecoxib Combined with Xeloda Metronomic Chemotherapy in the Treatment of the Elderly with Advanced Gastric Cancer

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