目的 探讨卡培他滨分别联合紫杉醇和奥沙利铂对术后转移复发胃癌患者生存期及肿瘤标记物的影响。方法 选取2019-01至2021-01解放军联勤保障部队第960医院收治的术后复发或转移胃癌患者101例,根据治疗方式将患者分为卡培他滨联合紫杉醇方案组(T组,n=51)、卡培他滨联合奥沙利铂方案组(O组,n=50)。比较两组近期、远期疗效,化疗前、后肿瘤标志物水平,毒副反应发生率。结果 两组近期临床疗效总有效率比较差异无统计学意义,化疗后血清CEA[(21.19±1.60)ng/ml vs(20.83±1.53)ng/ml]、CA199[(53.94±3.26)U/ml vs(53.79±3.26)U/ml]、CA724[(27.11±1.57)U/ml vs(27.48±1.61)U/ml]水平比较,差异无统计学意义。截止2022-01,T组中位生存期为13个月(95% CI:11.932~14.068),O组中位生存期为13个月(95% CI:11.535~14.465);Log-rank检验显示,两组Kaplan-Meier曲线差异无统计学意义( χ2=0.443)。两组1~2度胃肠道反应、肝肾功能异常、手足综合征、血液或淋巴系统症状、3~4度肝肾功能异常、脱发发生率比较,差异无统计学意义。两组毒副反应经对症处理后均有所缓解。结论 卡培他滨联合紫杉醇与卡培他滨联合奥沙利铂对术后转移复发胃癌患者均具有较好的疗效,且安全性相似。
Abstract
Objective To compare the survival time, carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199) and carbohydrate antigen 724 (CA724) of patients with metastatic and recurrent gastric cancer after capecitabine combined with paclitaxel and oxaliplatin respectively.Methods A total of 101 patients with postoperative recurrence or metastasis of gastric cancer admitted to the 960th Hospital of the joint logistics support force of the PLA from January 2019 to January 2021 were selected. According to the treatment methods, the patients were divided into capecitabine combined with paclitaxel regimen group (T group, n=51) and capecitabine combined with oxaliplatin regimen group (O group, n=50). The short-term curative effects, the levels of tumor markers before and after chemotherapy, the incidence of adverse reactions between the two groups were compared respectively. The patients were followed up to observe the long-term efficacy.Results There was no significant difference in the total effective rate of short-term clinical efficacy between the two groups, and there were no significant level differences in serum CEA [(21.19±1.60) ng/mL vs (20.83±1.53) ng/mL], CA199[(53.94±3.26) U/mL vs (53.79±3.26) U/mL] and CA724 [(27.11±1.57) U/mL vs (27.48±1.61) U/mL]between the two groups after chemotherapy. By January 2022, the median survival time of group T was 13 months (95% CI: 11.932~14.068), and 13 months (95% CI: 11.932~14.068) for group O. Log-rank test showed that there was no significant difference in Kaplan-Meier curve between the two groups (Log χ2=0.443, P=0.506). There were no significant differences in the incidence of grade 1-2 gastrointestinal reactions, abnormal liver and kidney function, hand-foot syndrome, blood or lymphatic system symptoms, and incidence of hair loss, grade 3-4 abnormal liver and kidney function, and hair loss between the two groups (P>0.05). The toxic and side effects in both groups were relieved after symptomatic treatment.Conclusions Capecitabine combined with paclitaxel and capecitabine combined with oxaliplatin are both characterized by good curative effect in patients with postoperative metastasis and recurrence of gastric cancer, and their safety is similar.
关键词
转移复发胃癌 /
卡培他滨 /
紫杉醇 /
奥沙利铂 /
生存期
Key words
metastatic and recurrent gastric cancer /
capecitabine /
paclitaxel /
oxaliplatin /
survival time
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参考文献
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基金
山东省医药卫生科技发展计划项目(2017WS689)
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