S-1 combined with intrathoracic and intraperitoneal injection chemotherapy in the treatment of advanced gastric cancer of aged patients / 肿瘤研究与临床

ABSTRACT

Objective To observe the short-term efficacy and adverse reactions of S-1 combined intrathoracic and intraperitoneal injection for the treatment of aged patients with gastric cancer and with malignant hydrothorax and ascites.Methods The patients were divided into treatment group (A group,22 cases) randomly and control group (B group,24 cases).The two groups underwent intrathoracic and intraperitoneal injection chemotherapy and biological therapy.Drainage tubes were placed in thoracic or abdominal cavity to discharge the effusion,cisplatin 40-60 mg,lentinan 4-6 mg,dexamethasone 10 mg were injected into the chest or abdomen,once per week,administered for 2-4 weeks.S-1 was added to the treatment group,S-1 capsules were administered orally on the first day of serous cavity drug injection,40-60 mg/m2,2 times per day,oral administration after morning and evening meal for 14 days,stop for 7 days,21 days were 1 cycle.The short-term curative effects,clinical quality of life and adverse reactions were compared between the two groups.Results Total effective rate of group A was 77.3 ％,50.0 ％ in B group,the difference of short-term effects of two groups was with statistical significance (P ＜ 0.05).The improvement rates of quality of life (QOL) of group A and group B were 86.4 ％ and 70.1％ respectively,with significant difference in the two groups (P ＜ 0.05).The major adverse reactions were gastrointestinal reaction and bone marrow suppression,nausea and vomiting rate in A group was 54.5 ％ (12/22),grade Ⅲ-Ⅳ neutropenia was 54.5 ％ (4/22),significantly higher than that in B group,there was significant difference in two groups (P ＜ 0.05).No treatment related death.Conclusion There is curative effect of S-1 combined with cisplatin and lentinan in treatment of the aged patients of gastric carcinoma and malignant hydrothorax and ascites.Gastrointestinal side efforts and bone marrow suppression in treatment group have been observed,but it is tolerable.This scheme can improve the QOL of patients and prolong the survival period.