替吉奥胶囊联合奥沙利铂应用于进展期胃癌的有效性和安全性

目的 探讨替吉奥胶囊联合奥沙利铂治疗进展期胃癌的有效性和安全性.方法 选取进展期胃癌患者64例,根据化疗方案的不同分为观察组(n=32)和对照组(n=32).对照组采取全身静脉化疗(FOLFOX6:奥沙利铂+亚叶酸钙+5-氟尿嘧啶),观察组应用奥沙利铂联合替吉奥胶囊治疗,21 d为1周期,共治疗4个周期.观察2组近期疗效及不良反应发生情况,检测并比较2组血清肿瘤标志物水平、外周血T淋巴细胞亚群及NK细胞变化.结果 观察组ORR和DCR分别为46.88%、90.63%,对照组分别为43.75%、68.75%,观察组DCR明显高于对照组(P<0.05).与治疗前比较,治疗后2组CD4+、CD8+及NK细胞比例均显著降低,但观察组CD8+比例低于对照组,CD4+及NK细胞比例高于对照组(P<0.05或P<0.01);治疗后对照组CD4+/CD8+比值降低,观察组CD4+/CD8+比值明显增加,且显著高于对照组(P<0.01).治疗后2组血清CEA、CA125、SCC-Ag水平均明显降低,且观察组显著低于对照组(P<0.01).观察组Ⅲ﹢Ⅳ级胃肠道反应及骨髓抑制患者比例低于对照组(P<0.05).结论 替吉奥胶囊联合奥沙利铂治疗进展期胃癌的近期疗效显著,可明显降低血清肿瘤标志分子水平,保护其免疫功能,并具有一定的安全性.

Study on the Efficacy and Safety of Tegafur Capsules Combined with Oxaliplatin for Advanced Gastric Cancer

Objective To investigate the efficacy and safety of tegafur capsules combined with oxaliplatin in the treat-ment of advanced gastric cancer. Methods 64 patients with advanced gastric cancer were selected, according to the different chemotherapy regimens were divided into the observation group ( n=32 ) and the control group ( n=32 ) . The control group re-ceived systemic intravenous chemotherapy ( FOLFOX6:oxaliplatin+leucovorin+5-fluorouracil) ,the observation group was trea-ted with oxaliplatin plus and tegafur capsules. 21 d for 1 cycle,a total of 4 cycles of treatment. The short-term curative effect and adverse reactions were observed,The levels of serum tumor markers,peripheral blood T lymphocyte subsets and NK cells were de-tected and compared. Results ORR and DCR of the observation group were 46. 88% and 90. 63% respectively,and the control group were 43. 75% and 68. 75% respectively. DCR of the observation group was significantly higher than that of the control group (P<0. 05). Compared with the control group,the proportion of CD4 +,CD8 +and NK cells in the 2 groups was significantly lower than that of the control group,but the proportion of CD4 +and NK cells in the observation group was lower than that of the control group (P<0. 05 or P<0. 01);After treatment,the ratio of CD4 + /CD8 +in the control group decreased,and the ratio of CD4 + /CD8 +in the observation group was significantly higher than that of the control group (P <0. 01). The levels of serum CEA,CA125 and SCC-Ag in the 2 groups were significantly lower than those of the control group (P<0. 01). The proportion of patients with Ⅲ+Ⅳgrade gastrointestinal tract reaction and myelosuppression was lower than that of the control group ( P <0. 05). Conclusion The short-term efficacy of tegafur capsules combined with oxaliplatin in the treatment of advanced gastric cancer can significantly reduce the molecular level of serum tumor markers,protect the immune function,and has certain safety.