摘要
目的 探讨胃癌临床多学科综合治疗模式下药物治疗的序贯选择的疗效优化策略,评估不同治疗方案对患者生存期和生活质量的影响,提出个体化治疗的优化路径。方法 本研究采用前瞻性观察性设计,选取武平县医院肿瘤内科2023年1月至2024年6月间收治的胃癌患者共120例,所有患者均接受胃癌标准多学科综合治疗(MDT),其中包括手术、放疗、化疗及靶向治疗等。患者按药物治疗的序贯方式分为3组:传统化疗序贯组、化疗联合靶向治疗序贯组及化疗联合免疫治疗序贯组。所有患者在治疗期间接受定期评估,包括临床疗效评估、药物不良反应监测和生活质量评分。主要疗效指标为无进展生存期(PFS)和总生存期(OS),次要指标为治疗相关不良反应发生率和生活质量评分变化。结果 与传统化疗序贯组相比,化疗联合靶向治疗序贯组的PFS显著延长(12.5个月vs.9.2个月,P<0.05),免疫治疗联合化疗序贯组的PFS为15.3个月,显著优于其他两组(P<0.05)。OS在免疫治疗组表现最佳,达到26.2个月,明显优于传统化疗组(OS为20.5个月)和化疗联合靶向组(OS为22.8个月)。治疗相关不良反应在免疫治疗组和靶向治疗组较轻,治疗耐受性较好。生活质量评分在免疫治疗组改善最为显著,尤其是在体力活动、疼痛控制和情绪稳定方面。结论 胃癌多学科综合治疗中,药物治疗的序贯选择对患者的生存期、生活质量具有显著影响。免疫治疗联合化疗的序贯治疗方案在提高OS、延长PFS及改善生活质量方面表现出良好的疗效。
Objective To explore the sequential efficacy optimization strategy of drug treatment in the clinical multidisciplinary comprehensive treatment mode of gastric cancer,evaluate the impact of different treatment options on patient survival and quality of life,and propose the optimization path of individualized treatment.Methods This study adopted a prospective observational design,selecting 120 gastric cancer patients admitted to the Department of Oncology at Wuping County Hospital from January 2023 to June 2024.All patients received standard multidisciplinary treatment(MDT)for gastric cancer,which included surgery,radiotherapy,chemotherapy,and targeted therapy.Patients were divided into three groups based on the sequence of drug treatments:traditional chemotherapy followed by other treatments,chemotherapy combined with targeted therapy,and chemotherapy combined with immunotherapy.All patients underwent regular assessments during the treatment period,including clinical efficacy evaluation,monitoring of adverse drug reactions,and quality of life scoring.The primary endpoints were progression-free survival(PFS)and overall survival(OS),while secondary endpoints included the incidence of treatment-related adverse reactions and changes in quality of life scores.Results Compared with the conventional chemotherapy,the PFS was significantly prolonged(12.5 vs.9.2 months,P<0.05),and the PFS of the immunotherapy combined with chemotherapy was 15.3 months,which was significantly better than the other two groups(P<0.05).Overall survival(OS)was best in the immunotherapy group at 26.2 months,significantly better than the traditional chemotherapy group(OS 20.5 months)and the chemotherapy combined targeted group(OS 22.8 months).Treatment-related adverse effects were mild in immunotherapy and targeted therapy groups and well tolerated.The QOL score improved most significantly in the immunotherapy group,especially in physical activity,pain control,and mood stability.Conclusions In the multidisciplinary comprehensive treatment of gastric cancer,sequential selection of drug therapy has a significant impact on patients’survival period and quality of life.Sequential treatment regimen of immunotherapy combined with chemotherapy shows good efficacy in improving overall survival,prolonging progression-free survival and improving quality of life.
作者
吴华鑫
林远平
WU Huaxin;LIN Yuanping(Department of Oncology,Wuping County Hospital,Longyan,Fujian 364300,China)
出处
《中国医药指南》
2025年第18期62-65,共4页
Guide of China Medicine
基金
河南阳光医疗健康发展基金(HKP2024001)。
关键词
胃癌
多学科综合治疗
药物序贯治疗
免疫治疗
生存期
Gastric cancer
Multidisciplinary comprehensive treatment
Drug sequential treatment
Immunotherapy
Survival period
