作者：孙宇，王小群，陈景耀，张华

单位：中山大学附属第七医院消化医学中心，广东 深圳 518000

Authors: Sun Yu, Wang Xiaoqun, Chen Jingyao, Zhang Hua

Unit:  Digestive Disease Center of the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518101, Guangdong, China

摘要：

目的  观察替吉奥+奥沙利铂（S-1 and oxaliplatin，SOX）方案及卡培他滨+奥沙利铂（capecitabine and oxaliplatin，CAPOX）方案在胃肠道肿瘤辅助化疗、新辅助化疗及姑息化疗中的血液毒副作用，为临床治疗提供依据。方法  回顾性分析中山大学附属第七医院消化医学中心2017年5月至2023年9月的胃肠道肿瘤患者共57例，其中患者予SOX 或CAPOX 行辅助、新辅助或一线姑息化疗，方案每3 周重复，至辅助化疗结束或者转二线姑息化疗。观察严重血液毒副作用的发生率。结果  SOX 组和CAPOX 组比较，3~4 度白细胞减少和3~4 度贫血的发生率无统计学差异（P=0.40，0.11）。与CAPOX 组相比，SOX 组3~4 度血小板减少的发生率更高（P＜0.01），发生时间更早（P＜0.01）。结论  SOX方案的3~4度血小板减少更常见，发生时间更早。建议在SOX方案中，对血小板减少进行积极的二级预防。

关键词： 胃肠道肿瘤；血液毒副作用；卡培他滨；替吉奥；奥沙利铂

Abstract：

Objective  To observe the hematological toxicity side effects of the S-1 and oxaliplatin (SOX) regimen and capecitabine and oxaliplatin (CAPOX) regimen in adjuvant, neoadjuvant or palliative chemotherapy for gastrointestinal tumors. Method  A retrospective analysis was conducted on 57 patients diagnosed with gastrointestinal tumors at the Digestive Disease Center of the Seventh Affiliated Hospital of Sun Yat-sen University from May 2017 to September 2023. These patients underwent treatment with the SOX or CAPOX regimens for adjuvant, neoadjuvant, or first-line palliative chemotherapy. The treatment cycles were repeated every 3 weeks until chemotherapy completion or transition to second-line palliative chemotherapy. The incidence of severe hematological toxicity side effects was observed. Result  No statistical difference in grade 3-4 leukopenia or grade 3-4 anemia was noted between the SOX and CAPOX groups (P=0.40 and 0.11, respectively). However, the SOX group had a notably higher incidence of grade 3-4 thrombocytopenia (P约0.01). Additionally, the onset of thrombocytopenia was earlier in the SOX group compared to the CAPOX group (P约0.01). Conclusion  Grade 3-4 thrombocytopenia occurs more frequently and earlier in the SOX group than in the CAPOX group. Proactive secondary treatment for thrombocytopenia is strongly recommended during SOX therapy.

Key Words:  Gastrointestinal tumor；Hematological toxicity side effect；Capecitabine; S-1；Oxaliplatin