摘要
目的探讨分子标志物切除修复交叉互补基因1(ERCC1)指导晚期胃癌治疗的疗效。方法 93例晚期初治胃癌患者,ERCC1阳性表达组(A组,28例)采用希罗达+紫杉醇(XT方案)化疗,ERCC1阴性表达组(B组,26例)采用希罗达+奥沙利铂(XELOX方案)化疗,未行ER-CC1检测的患者随机选择XT方案(C组,20例)或XELOX方案(D组,19例)化疗,观察指标为总有效率(RR)、无进展生存时间(PFS)、总生存时间(OS)。结果入组93例患者中位随访20个月,4组方案RR分别为A组57.0%、B组54.0%、C组35.0%和D组32.0%,差异无统计学意义。4组方案中位PFS分别为A组7.2个月、B组7.0个月、C组5.0个月和D组4.9个月(P<0.05)。中位OS分别为A组12.8个月、B组12.9个月、C组10.1个月和D组9.5个月(P<0.05)。亚组分析显示,体能状态评分0～1分组、2分组PFS分别为8.1和4.2个月,中位OS分别为15.8个月和7.5个月,体能状态良好者的生存时间长于ERCC1分层治疗的生存时间。结论 ERCC1分子标志物指导下的分层治疗能显著提高晚期胃癌一线治疗疗效,但体能状态仍是影响晚期胃癌患者预后的主要因素。
Objective The study aimed to select chemotherapy regimen based on guidance of the molecular marker ERCC1 and observe the prognosis of advanced gastric cancer.Methods 93 cases of untreated advanced gastric cancer patients were enrolled,and patients with ERCC1-positive expression（group A） received Xeloda and paclitaxel（XT） regimen,while those with ERCC1-negative expression（group B）received Xeloda and oxaliplatin（XELOX） regimen.Patients who didn＇t perform ERCC1 detection randomly recieved XT（group C） or XELOX（group D）regimen.Results 93 patients were enrolled in the study,and median follow-up time was 20 months for all patients.The RR of group A was 57.0%,group B was 54.0%,group C was 35.0% and group D was 32.0%,respectively,but the difference was not statistically significant;the median PFS in the four groups（ABCD） were 7.2,7.0,5.0 and 4.9 months,respectively（P0.05）,and median OS were 12.8 months and 12.9 months,10.1 months and 9.5 months,respectively（P0.05）.Subgroup analysis showed that in the patients with performance status（PS） scored at 0 to 1 point and 2 points,median PFS was 8.1 and 4.2 months,respectively,and median OS was 15.8 and 7.5 months,respectively.Patients with good PS showed longer survival time than those with ERCC1 stratified treatment.Conclusions Stratified treatment under the guidance of ERCC1 molecular marker can obviously improve the prognosis of advanced gastric cancer in the first-line setting,but PS is still the main factor that influences the prognosis of patients with advanced gastric cancer.
出处
《中国肿瘤临床与康复》
2012年第6期502-505,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
分子标志物
胃肿瘤
Molecular marker
Gastric neoplasms
