FOLFOX4、SOX化疗方案治疗晚期胃癌的疗效及对血清生物活性因子及预后的影响

Therapeutic effect of FOLFOX4 and SOX chemotherapy in advanced gastric cancer and its influence on serum biological activity factors and prognosis

目的探讨奥沙利铂+亚叶酸钙+5-氟尿嘧啶(FOLFOX4)、奥沙利铂+替吉奥(SOX)化疗方案治疗晚期胃癌的疗效及对血清基质金属蛋白酶9(MMP9)、CD44v6、血管内皮细胞生长因子C(VEGFC)、转化生长因子-β1(TGF-β1)水平和预后的影响。方法根据治疗方法不同将112例晚期胃癌患者分为对照组与观察组,每组56例。对照组患者采用FOLFOX4方案化疗,观察组患者采用SOX方案化疗。比较两组患者的近期疗效、远期生存情况、不良反应发生情况,并对两组患者治疗前后的血清MMP9、CD44v6、VEGFC、TGF-β1水平进行比较。结果治疗结束后,两组患者的疾病控制率、客观缓解率比较,差异均无统计学意义(P﹥0.05)。化疗过程中,两组患者白细胞减少、血小板减少、乏力、恶心、呕吐、口腔黏膜炎、肝肾功能不全、神经功能异常的发生率比较,差异均无统计学意义(P﹥0.05)。两组患者治疗后的血清MMP9、CD44v6、VEGFC、TGF-β1水平均明显低于本组治疗前(P﹤0.01);观察组患者治疗后的血清MMP9、CD44v6、VEGFC、TGF-β1水平均低于对照组治疗后(P﹤0.05)。观察组患者的2年生存率高于对照组(P﹤0.05)。结论SOX化疗方案治疗晚期胃癌的远期疗效优于FOLFOX4方案,可能与降低血清MMP9、CD44v6、VEGFC、TGF-β1水平有关。

Objective To observe the effects of chemotherapy applying oxalipatin+calcium folinate+5-fluorouracil(FOLFOX4)or oxalipatin+tegafur/gimeracil/oteracil(SOX)in advanced gastric carcinoma and their influence on serum levels of matrix metalloproteinase-9(MMP9),CD44v6,vascular epithelial growth factor C(VEGFC),transforming growth factorβ1(TGF-β1)and prognosis.Method A total of 112 cases with advanced gastric carcinoma treated by different therapies were included in the study as control group and study group,with 56 cases in each,respectively.The control group was treated with FOLFOX4 regimen,and study group with SOX regimen.The short-term efficacy,long-term survival,adverse reactions and serum levels of MMP9,CD44v6,VEGFC,and TGF-β1 before and after treatment were compared between the two groups.Result After treatment,the disease control rate and objective response rate in both groups were of no statistically significant differences(P>0.05).During chemotherapy,there were no significant differences regarding the incidence of leukopenia,thrombocytopenia,fatigue,nausea,vomiting,oral mucositis,liver and kidney dysfunction and neurological abnormalities between the two groups(P>0.05).The levels of serum MMP9,CD44v6,VEGFC and TGF-β1 in the two groups after treatment were significantly decreased compared to that before treatment(P<0.01);and the levels of serum MMP9,CD44v6,VEGFC and TGF-β1 in study group were significantly lower than those in control group after treatment(P<0.05).The 2-year survival rate in study group was significantly higher than that in control group(P<0.05).Conclusion The long-term efficacy of SOX chemotherapy in the treatment of advanced gastric cancer is better compared to FOLFOX4 regimen,which may be related to the reduction of serum levels of MMP9,CD44v6,VEGFC and TGF-β1.