贝伐单抗与卡培他滨联合奥沙利铂对术后老年晚期胃癌血清CA199、CEA、CA242及生活质量的影响

目的 探讨老年晚期胃癌患者术后采用贝伐单抗与卡培他滨联合奥沙利铂方案治疗临床疗效,并观察其对患者血清肿瘤标志物及生活质量的影响.方法 60例经手术组织病理证实为晚期胃癌患者,均行腹腔镜胃癌根治术治疗,术后对照组(30例)予以多西他赛注射液+顺铂+氟尿嘧啶;治疗组(30例)给予奥沙利铂注射液+贝伐单抗+卡培他滨片.检测两组患者治疗前、后血清肿瘤标志物变化,记录两组患者疾病进展时间及平均生存时间;采用采用医院自制问卷调查表对患者生活质量进行调查.统计两组患者临床疗效及不良反应.结果 治疗组治疗后CA199、CA242及CEA水平分别为(194.2±45.8)mg/L、(32.9±8.1)mg/L、(18.1±6.2)mg/L,明显低于对照组(279.6±46.9)mg/L、(58.7±8.8)mg/L、(29.7±7.4)mg/L,t=(7.13,11.81,6.58),P=(0.00,0.00,0.00);两组各项血清肿瘤标志物水平均明显低于治疗前,P<0.05.治疗组疾病进展时间、平均生存时间分别为(6.2±3.1)个月、(11.8±4.2)个月,明显长于对照组[(4.1±2.0)个月、(7.9±1.9)个月],t=(3.11,4.63),P=(0.00,0.00).经干预后,治疗组患者躯体症状、睡眠质量、精神状态、社会情感积分明显明显高于对照组,P<0.05;治疗组治疗总有效率(76.7％),明显高于对照组(43.3％),x2=6.94,P=0.00;治疗组不良反应率(20.0％)明显低于对照组(53.3％),x2=7.17,P=0.00.结论 老年晚期胃癌患者术后采用贝伐单抗与卡培他滨联合奥沙利铂方案治疗疗效显著且不良反应少,有利于改善患者生活质量及延长其生存期.

Effects of Bevacizumab and Capecitabine Combined with Oxaliplatin on Serum CA199,CEA,CA242 and Quality of Life in Elderly Patients with Advanced Gastric Cancer

Objective To explore the clinical effect of bevacizumab and capecitabine combined with oxaliplatin in the treatment of elderly patients with advanced gastric cancer,and its effect on serum tumor markers and quality of life.Methods All the patients were treated with laparoscopic radical gastrectomy for gastric carcinoma.Docetaxel 75 mg/kg was given to the patients with advanced gastric cancer after operation.The patients were treated with docetaxel 75 mg/m2,the first day,75 mg/m2 cisplatin,the first day,the first 5 days of intravenous infusion of fluorouracil 75 mg/(m2·d),pumped 25 h,once every 3 weeks for the control group,30 patients in the treatment group were given intravenous infusion of 120 mg/m2 oxaliplatin on the first day,and bevacizumab 7.5 mg/m2 intravenously on the 1st to the 14th day,while taking capecitabine tablets at 2 000 mg/m2,The daily oral 2 times.The changes of serum tumor markers before and after treatment were recorded.The time of disease progression and the mean survival time were recorded.The quality of life of the patients was investigated by hospital-made questionnaires.The clinical efficacy and side effects were analyzed.Results The levels of CA199,CA242 and CEA in the treatment group were(194.2±45.8)mg/L,(32.9±8.1)mg/L and(18.1±6.2)mg/L,respectively,which were significantly lower than those of the control group(279.6±46.9)(28.7±8.8)mg/L,(29.7±7.4)mg/L,t=(7.13,11.81,6.58),P=(0.00,0.00,0.00);serum tumor markers level was significantly lower than before treatment,P<0.05.The mean survival time of the patients in the treatment group was(6.2±3.1)months,(11.8±4.2)months,which was significantly longer than the control group(4.1±2.0)months,(7.9±1.9)months,t=(3.11,4.63),P=(0.00,0.00).The total effective rate of the treatment group was(76.7％),which was significantly higher than that of the control group(43.3％),x2 =6.94(P<0.05).After treatment,the scores of physical symptoms,sleep quality,mental state and social emotion of the treatment group were significantly higher than those of the control group,P=0.00.The adverse reaction rate of the treatment group was(20.0％),which was significantly lower than that ofthe control group(53.3％),x2=7.17,P=0.00.Conclusion Patients with advanced gastric cancer after treatment with bevacizumab and capecitabine combined with oxaliplatin regimen has significantly fewer adverse effects,it helps to improve the quality of life of patients and prolong their survival.