局部晚期或转移性胃食管腺癌的姑息化疗的应用和疗效。
Utilization and Efficacy of Palliative Chemotherapy for Locally Advanced or Metastatic Gastroesophageal Carcinoma.
机构信息
Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
Comprehensive Cancer Center Vienna, Gastroesophageal Tumor Unit, Medical University of Vienna, Vienna, Austria.
出版信息
Anticancer Res. 2020 Feb;40(2):965-975. doi: 10.21873/anticanres.14030.
BACKGROUND/AIM: A standard treatment recommendation for advanced stage gastroesophageal cancer is still missing.
PATIENTS AND METHODS
We retrospectively analyzed clinical data of patients with inoperable locally advanced or metastatic gastroesophageal cancer treated between 2001 and 2017 at the Vienna General Hospital, Austria.
RESULTS
Administration of systemic therapy was positively associated with overall survival (OS) (469 days vs. 185 days; p<0.001), while palliative gastrectomy or radiotherapy showed no correlation. OS was significantly longer in patients receiving capecitabine/oxaliplatin (XELOX) vs. leucovorin/5-FU/oxaliplatin (FOLFOX) (600 days vs. 327 days, p<0.05). Comparison of doublet vs. triplet chemotherapies showed no difference in OS, but triplet chemotherapy resulted in more adverse events. The anti-HER2-antibody trastuzumab doubled OS (836 days vs. 399 days, p=0.053).
CONCLUSION
Capecitabine may be preferably used over infused 5-FU and doublet chemotherapy over triplet chemotherapy in the first-line palliative setting of advanced gastroesophageal cancer.
背景/目的：对于晚期胃食管交界癌，仍然缺乏标准的治疗推荐。
患者和方法
我们回顾性分析了奥地利维也纳总医院 2001 年至 2017 年间治疗的不可切除的局部晚期或转移性胃食管交界癌患者的临床数据。
结果
系统治疗的应用与总生存期（OS）呈正相关（469 天比 185 天；p<0.001），而姑息性胃切除术或放疗则没有相关性。接受卡培他滨/奥沙利铂（XELOX）治疗的患者的 OS 明显长于接受亚叶酸/5-FU/奥沙利铂（FOLFOX）治疗的患者（600 天比 327 天，p<0.05）。与双药化疗相比，三药化疗在 OS 方面没有差异，但三药化疗导致更多的不良反应。抗 HER2 抗体曲妥珠单抗使 OS 翻倍（836 天比 399 天，p=0.053）。
结论
卡培他滨可能优于输注 5-FU，双药化疗可能优于三药化疗，作为晚期胃食管交界癌一线姑息治疗的选择。
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