替吉奥联合奥沙利铂化疗治疗老年胃癌疗效观察

目的 探讨替吉奥联合奥沙利铂化疗方案对老年胃癌患者临床疗效、毒副反应及肿瘤内分泌指标的影响.方法 选取2013年6月至2016年5月我院收治的82例老年胃癌患者为研究对象,按随机数表法分为观察组和对照组,每组41例.对照组采用5-氟尿嘧啶(5-FU)+奥沙利铂+亚叶酸钙方案治疗,每21 d为一个疗程,共治疗3个疗程;观察组采用替吉奥+奥沙利铂方案治疗,每21 d为一个疗程,共治疗3个疗程.3个疗程治疗结束后比较两组患者的临床疗效、毒副反应及治疗前、后肿瘤内分泌指标.结果 观察组患者的治疗总有效率为53.66%,明显高于对照组的31.71%,差异有统计学意义(P<0.05);观察组和对照组患者治疗期间白细胞减少Ⅰ、Ⅱ度发生率(34.15%vs 60.98%、7.32%vs 24.39%)、中性粒细胞减少Ⅰ、Ⅱ度发生率(26.83%vs 48.79%、4.88%vs 24.39%)、恶心呕吐Ⅰ、Ⅱ度发生率(46.34%vs 73.17%、2.44%vs 19.51)比较,观察组均低于对照组,差异均有统计学意义(P<0.05);观察组患者治疗前的肿瘤内分泌指标VEGFA、VEGFC、sVEGFR-1水平分别为(209.86±89.47)ng/L、(90.23±19.28)ng/L、(214.37±45.86)ng/L,分别与对照组的(203.15±82.66)ng/L、(87.26±21.35)ng/L、(217.53±49.81)ng/L比较,差异均无统计学意义(P>0.05);观察组患者治疗后的肿瘤内分泌指标VEGFA、VEGFC、sVEGFR-1水平分别为(103.88±68.51)ng/L、(38.16±10.57)ng/L、(537.48±61.32)ng/L,均低于对照组的(165.53±75.42)ng/L、(47.48±11.96)ng/L、(493.64±67.59)ng/L,差异均有统计学意义(P>0.05).结论 替吉奥联合奥沙利铂化疗能有效提高老年胃癌患者的临床疗效,并减轻毒副反应和改善肿瘤内分泌功能.

Effect of tegafur combined with oxaliplatin chemotherapy in elderly patients with gastric cancer

Objective To investigate the effect of tegafur combined with oxaliplatin, toxic side effects and tu-mor endocrine indexes in elderly patients with gastric cancer. Method A total of 82 elderly patients with gastric cancer were enrolled in our hospital from June 2013 to May 2016. The patients were divided into observation group (n=41) and control group (n=41) according to the random number table. The control group was treated with 5-fluorouracil (5-FU)+oxaliplatin+leucovorin regimen, every 21 d as one course, for 3 courses of treatment. The observation group was treated with tiggio+oxaliplatin, every 21 d as one course, for 3 courses of treatment. After 3 courses of treatment, the clinical ef-ficacy, toxic side effects and tumor endocrine indexes of the two groups were compared. Results The total effective rate of the observation group was 53.66%, which was significantly higher than 31.71%of the control group (P<0.05). During the treatment, the incidence rates of leukopeniaⅠ,Ⅱdegree (34.15%vs 60.98%, 7.32%vs 24.39%), neutrope-niaⅠ,Ⅱdegree (26.83%vs 48.79%, 4.88%vs 24.39%), and nausea and vomitingⅠ,Ⅱdegree (46.34%vs 73.17%, 2.44%vs 19.51) in the observation group were significantly lower than those in the control group (P<0.05). The expres-sion levels of VEGFA, VEGFC and sVEGFR-1 in the observation group of patients before treatment respectively were (209.86±89.47) ng/L, (90.23±19.28) ng/L, (214.37±45.86) ng/L, respectively, and the levels in the control group were (203.15 ± 82.66) ng/L, (87.26 ± 21.35) ng/L, (217.53 ± 49.81) ng/L. The difference was not significant (P>0.05). The ex-pression of VEGFA, VEGFC and sVEGFR-1 in the observation group of patients after treatment respectively were (103.88 ± 68.51) ng/L, (38.16 ± 10.57) ng/L, (537.48 ± 61.32) ng/L, which were lower than (165.53 ± 75.42) ng/L, (47.48 ± 11.96) ng/L, (493.64 ± 67.59) ng/L in the control group (P<0.05). Conclusion Tegafur combined with oxaliplatin che-motherapy can effectively improve the clinical efficacy of elderly patients with gastric cancer, reduce toxicity, and im-prove the patient's tumor endocrine.