摘要
目的探讨进展期胃癌患者应用奥沙利铂、氟尿嘧啶和亚叶酸钙(FOLFOX4)方案联合曲妥珠单抗治疗的临床效果及安全性。方法选取2021年10月—2022年10月该院收治的82例进展期胃癌患者为研究对象,按随机数表法将其分为对照组与观察组,对照组(n=41)单一应用FOLFOX4方案治疗,观察组(n=41)联合应用FOLFOX4方案与曲妥珠单抗治疗。对比两组的临床缓解率、肿瘤标志物、新生血管标志物、1年生存率、不良反应。结果观察组临床缓解率为85.37%,高于对照组的65.85%,差异有统计学意义(P<0.05)。治疗前,两组细胞角蛋白19片段抗原211(CYFRA211)、癌胚抗原(CEA)、糖类抗原153(CA153)、色素上皮衍生因子(PEDF)、内皮细胞特异性分子-1(ESM-1)、血管内皮生长因子(VEGF)表达比较,组间差异无统计学意义(P>0.05);治疗后,观察组CYFRA211为(13.42±2.24)ng/mL,CEA为(25.72±3.35)ng/mL,CA153为(37.59±4.06)U/mL,PEDF为(43.48±9.95)ug/L,ESM-1为(0.74±0.19)ug/L,VEGF为(66.83±4.12)ng/L,均低于对照组的(15.19±3.06)ng/mL、(28.91±3.14)ng/mL、(39.95±6.11)U/mL、(47.85±9.68)ug/L、(0.99±0.15)ug/L、(70.75±5.05)ng/L,组间差异有统计学意义(P<0.05)。观察组1年生存率为82.93%,高于对照组的63.41%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论进展期胃癌患者应用FOLFOX4方案进行化疗同时加用曲妥珠单抗,能够下调肿瘤标志物表达,抑制肿瘤血管新生,提高生存率,疾病缓解效果确切,并且安全性高,未出现严重不良反应。
Objective To investigate the clinical efficacy and safety of oxaliplatin,fluorouracil and leucovorin(FOLFOX4)regimen combined with trastuzumab in the treatment of patients with advanced gastric cancer.Methods 82 patients with advanced gastric cancer admitted to this hospital from October 2021 to October 2022 were selected as the research objects,and were divided into a control group and an observation group by random number table method.The control group(n=41)was treated with FOLFOX4 regimen alone,and the observation group(n=41)was treated with FOLFOX4 regimen and trastuzumab.The clinical remission rate,tumor markers,neovascularization markers,1-year survival rate,and adverse reactions were compared between the two groups.Results The clinical remission rate of the observation group was 85.37%,which was higher than 65.85%of the control group,and the difference was statistically significant(P<0.05).Before treatment,the expressions of cytokeratin 19 fragment antigen 211(CYFRA211),carcinoembryonic antigen(CEA),carbohydrate antigen 153(CA153),pigment epithelium-derived factor(PEDF),endothelial cell s pecific molecule-1(ESM-1)and vascular endothelial growth factor(VEGF)were compared between the two groups.There was no significant difference between the two groups(P>0.05);after treatment,in the observation group,CYFRA211 was(13.42±2.24)ng/mL,CEA was(25.72±3.35)ng/mL,CA153 was(37.59±4.06)U/mL,PEDF was(43.48±9.95)ug/L,ESM-1 was(0.74±0.19)ug/L,VEGF was(66.83±4.12)ng/L,which were lower than(15.19±3.06)ng/mL,(28.91±3.14)ng/mL,(39.95±6.11)U/mL,(47.85±9.68)ug/L,(0.99±0.15)ug/L,(70.75±5.05)ng/L in the control group,respectively.The differences between the two groups were statistically significant(P<0.05).The 1-year survival rate of the observation group was 82.93%,which was higher than 63.41%of the control group,and the difference was statistically significant(P<0.05).Comparison of adverse reactions between two groups,the differences was not statistically significant(P>0.05).Conclusion FOLFOX4 chemotherapy combined with trastuzumab can down-regulate the expression of tumor markers,inhibit tumor angiogenesis and improve survival rate in patients with advanced gastric cancer.The disease remission effect is definite,and the safety is high,and no serious adverse reactions occur.
作者
吕倩
LYU Qian(DepartmentⅡof Oncology,Shouguang People's Hospital,Weifang Shandong,262700,China)
出处
《反射疗法与康复医学》
2024年第7期77-80,共4页
Reflexology And Rehabilitation Medicine
