周婷 李鹰飞 李锄云

摘 要 目的：探讨雷替曲塞联合紫杉醇一线治疗晚期胃癌的临床效果。方法：选择晚期胃癌患者82例随机分为对照组和观察组各41例。对照组采用氟尿嘧啶（5-FU）联合紫杉醇方案治疗，观察组采用雷替曲塞联合紫杉醇方案治疗，21 d为1治疗周期，连续治疗2个周期后对比两组临床疗效、不良反应。结果：化疗后，两组治疗总有效率和控制率比较差异无统计学意义（P=0.142，P=0.284）；两组均出现以骨髓毒性和肠道反应为主的毒副反应，且多数为Ⅰ～Ⅱ度，且观察组骨髓毒性和肠道反应发生率低于对照组（P=0.023，P=0.012）。结论：雷替曲塞联合紫杉醇一线治疗晚期胃癌，临床效果显著，且能够降低不良反应的发生率。

关键词 雷替曲塞 紫杉醇 晚期胃癌 临床效果 不良反应

中图分类号：R979.12； R735.2 文献标志码：B 文章编号：1006-1533（2021）03-0018-03

Clinical effects of raltitrexed combined with paclitaxel in the first-line treatment of advanced gastric cancer

ZHOU Ting*， LI Yingfei， LI Chuyun

（Department of Oncology， the First Peoples Hospital of Fuzhou， Jiangxi Fuzhou 344000， China）

ABSTRACT Objective： To investigate the clinical effect of raltitrexed combined with paclitaxel on advanced gastric cancer. Methods： Eighty-two patients with advanced gastric cancer were randomly divided into a control group and an observation group. The control group was treated with fluorouracil （5-FU） combined with paclitaxel regimen， and the observation group was treated with raltitrexed combined with paclitaxel regimen for 21 days. After two consecutive cycles， the clinical efficacy and adverse reactions were compared between the two groups. Results： After chemotherapy， there were no significant differences in overall response rate and control rate between the two groups （P=0.142， P=0.284）. The adverse reactions were mainly bone marrow toxicity and intestinal reactions in both groups， and most of them belonged to I～II degrees. The incidence of bone marrow toxicity and intestinal reactions was lower in the observation group than the control group （P=0.023， P=0.012）. Conclusion： Raltitrexed combined with paclitaxel is effective in the first-line treatment of advanced gastric cancer.

KEY WORDS raltitrexed； paclitaxel； advanced gastric cancer； clinical effect； adverse reactions

胃癌是常見的消化道肿瘤之一，死亡率较高，早期缺乏明显临床症状，大部分患者均在晚期才得到确诊，失去了治疗的最佳时机[1-2]。对于晚期胃癌患者，单纯依靠扩大切除范围进行治疗无法改变其预后效果，临床上主要治疗方式为化疗[3]。本研究旨在探讨雷替曲塞联合紫杉醇一线治疗晚期胃癌的临床效果。

1 资料与方法

1.1 临床资料

选取2018年8月—2019年8月我院收治的晚期胃癌患者82例为研究对象，随机分为对照组和观察组各41例。对照组：男26例，女15例，年龄29～71岁，平均年龄（45.28±3.54）岁。观察组：男23例，女18例，年龄30～72岁，平均年龄（44.82±3.75）岁。两组患者性别、年龄等一般资料比较差异无统计学意义（P>0.05），具有可比性。纳入标准：①两组患者均已经过病理组织学确诊为晚期胃癌；②……