白蛋白结合型紫杉醇联合替吉奥方案在胃癌术前新辅助化疗中的疗效分析

Efficacy of albumin-bound paclitaxel combined with the S-1 regimen in neoadjuvant chemotherapy for gastric cancer

目的评估白蛋白结合型紫杉醇联合替吉奥方案在局部晚期胃癌术前新辅助化疗中的疗效及安全性。方法选取2017年1月至2019年5月湖北省十堰市人民医院治疗的48例局部晚期胃癌患者作为研究对象,按照随机数字表法分为观察组(23例,应用白蛋白结合型紫杉醇+替吉奥方案化疗)和对照组(25例,应用FLOT方案化疗),两组患者均行新辅助化疗4周期,化疗4~6周后行D2根治术。比较两组患者的病理完全缓解(pathologic complete response,PCR)率、客观缓解率(objective response rate,ORR)、R0切除率、病理消退良好(major pathologic response,MPR)率、中位无进展生存时间(progression-free survival,PFS)、中位总生存时间(overall survival,OS)及不良反应情况。结果两组患者PCR率、R0切除率、ORR、MPR率、中位PFS、中位OS比较,差异无统计学意义(P>0.05)。两组患者血液学毒性、胃肠道反应方面,Ⅰ~Ⅳ级总不良反应发生率比较,差异无统计学意义(P>0.05)。观察组白细胞减少、中性粒细胞减少Ⅲ、Ⅳ级不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论白蛋白结合型紫杉醇联合替吉奥方案治疗局部晚期胃癌安全有效。

Objective To evaluate the efficacy and safety of albumin-bound paclitaxel combined with S-1 as neoadjuvant chemotherapy for patients with locally advanced gastric cancer.Methods A random number table was used to divide 48 patients with locally advanced gastric cancer at Shiyan City People’s Hospital from January 2017 to May 2019 into an observation group(23 patients who received chemotherapy with albuminbound paclitaxel+S-1)and a control group(25 patients who received chemotherapy with the FLOT regimen).All patients underwent pre-operative neoadjuvant chemotherapy for 4 cycles,and D2 radical resection was performed 4-6 weeks after chemotherapy.The pathologic complete response(PCR)rate,objective response rate(ORR),R0 resection rate,major pathologic response(MPR)rate,median overall survival(OS),median progression-free survival(PFS),and adverse reactions were compared between the two groups of patients.Results There was no significant difference in the PCR,R0 resection,ORR,and MPR rates,and median PFS and median OS between the two groups(P>0.05).The overall incidence of gradeⅠ-Ⅳhematologic toxicities and adverse gastrointestinal reactions was similar;however,compared with the control group,the incidence of gradeⅢandⅣadverse reactions,such as leukopenia and neutropenia,was significantly lower in the observation group(P<0.05).Conclusion Albumin-bound paclitaxel combined with the S-1 regimen is safe and effective in patients with locally advanced gastric cancer.