研究不同剂量奥沙利铂联合替吉奥对晚期胃癌患者化疗所致血小板减少的影响。

选取2014年8月至2016年5月在国家癌症中心／中国医学科学院北京协和医学院肿瘤医院内科收治的60例经病理诊断为晚期胃癌的患者，分为2组。A组患者SOX方案奥沙利铂给药剂量为100 mg/m²，B组患者SOX方案奥沙利铂给药剂量为130 mg/m²，其他相同。依据NCI-CTC 3.0版毒性分级标准对两组患者的不良反应进行观察和分级。采用SPSS 19.0软件进行统计分析，组间比较采用卡方检验。

SOX方案治疗晚期胃癌出现3/4度不良反应主要有贫血、白细胞减少、中性粒细胞减少、血小板减少、恶心及呕吐。A组3/4度血小板减少症发生比例6.67%，显著低于B组发生比例30.0%。影响血小板减少的因素包括奥沙利铂剂量［OR=3.846，95%CI（1.091~13.56），P=0.0286）］。

奥沙利铂剂量是影响SOX方案治疗晚期胃癌所致血小板减少的因素。

To study the efficacy of different dosages of oxaliplatin plus S-1 on thrombocytopenia for the treatment of advanced gastric cancer.

Between August 2014 and May 2016, a total of 60 advanced gastric cancer patients at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were recruited to the study, and divided into two groups. Arm A received oxaliplatin at a dose of 100 mg/m² and arm B receiving oxaliplatin at a dose of 130 mg/m², started with SOX therapy. Adverse events were graded according to the National Cancer Institute-Common Toxicity Criteria version 3.0. This study used SPSS 19.0 software to undertake statistical analysis. Comparison of groups was statistically analyzed with X² test. Two-sided P<0.05 was used to indicate a statistically significant difference.

In total, the most common grade 3/4 toxicities were anemia, leukopenia, neutropenia, thrombocytopenia, nausea and vomiting in the treatment of SOX therapy for advanced gastric cancer. The incidence ofgrade 3/4 thrombocytopenia in arm A was 6.67%, which was significantly lower in arm B with 30.0%. Grade 3/4 thrombocytopenia was significantly associated with the dose of oxaliplatin [OR=3.846, 95%CI (1.091~13.56), P=0.0286) ].

The dose of oxaliplatin was one of the factors which affected affects grade 3/4 thrombocytopenia in the treatment of SOX therapy for advanced gastric cancer patients.