替吉奥联合奥沙利铂治疗晚期胃癌的疗效

Efficacy of Tegafur, Gimeracil and Oteracil Potassium Combined with Oxaliplatin in the Treatment of Advanced Gastric Cancer

目的:研究替吉奥联合奥沙利铂治疗晚期胃癌的疗效及对患者癌胚抗原(CEA)、糖类抗原(CA)19-9、细胞角蛋白(CK)18、CK19水平的影响。方法 :选取2015年1月—2017年1月我院收治的92例晚期胃癌患者为研究对象,根据随机抽签法分成联合组和对照组,各46例。对照组予以单纯替吉奥治疗,体表面积低于1.25 m2者,使用剂量为80 mg/d;体表面积在1.25～1.50 m2者,使用剂量为100 mg/d;体表面积在1.50 m2以上者,使用剂量为120 mg/d。均于早、晚餐后分服,连续服用21 d,后休息14 d为1个周期。联合组在对照组基础上联合奥沙利铂治疗,130 mg/m2加入250～500 mL 5%的葡萄糖溶液静脉滴注,每21 d给药1次。比较两组近期疗效,治疗前后血清CEA、CA19-9、CK18、CK19水平,治疗前后卡氏(Karnofsky,KPS)评分以及不良反应发生情况。结果:联合组总有效率显著高于对照组,差异有统计学意义(P <0.05);治疗后联合组血清CEA、CA19-9、CK18、CK19水平显著低于对照组,差异有统计学意义(P <0.05);治疗后两组KPS评分显著高于治疗前,且联合组高于对照组,差异有统计学意义(P <0.05);联合组恶心呕吐发生率显著低于对照组,差异有统计学意义(P <0.05)。结论 :替吉奥联合奥沙利铂治疗晚期胃癌的临床疗效显著,可有效降低血清CEA、CA19-9、CK18、CK19水平,改善患者身体功能状态,减少不良反应的发生。

Objective:To study the effcacy of tegafur,gimeracil and oteracil potassium combined with oxaliplatin in the treatment of advanced gastric cancer and their effect on carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,cytokeratin(CK)18 and CK19 levels.Methods:92 patients with advanced gastric cancer admitted to our hospital from January 2015 to Ja nuary 2017 were selected as subjects investigated and randomly divided into a combined group and a control group,46 cases in each group.The patients in the control group were treated with tegafur,gimeracil and oteracil potassium alone.The dosage was 80 mg/day for the patients whose body surface area was<1.25 m2.The dosage was 100 mg/day for the patients whose body surface area was 1.25~1.50 m2.The dosage was 120 mg/day for the patients whose body surface area was>1.50 m2.All drugs were taken after breakfast and dinner for continuous 21 days,and the then patients rested 14 days as one cycle.The patients in the combined group were treated with oxaliplatin on the basis of the control group,wherein 130 mg/m2 drug was added into 250~500 mL 5%glucose solution for intravenous drip,once every 21 days.The short-term effcacy,serum CEA,CA19-9,CK18 and CK19 levels before and after treatment,Karnofsky(KPS)scores before and after treatment and adverse reactions occurred were compared between the two groups.Results:The total effective rate in the combined group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The levels of serum CEA,CA19-9,CK18 and CK19 in the combined group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The KPS scores in the two groups after treatment were significantly higher than those before treatment,and the scores in the combined group were higher than those in the control group,with statistically significant differences(P<0.05).The incidence of nausea and vomiting in the combined group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Tegafur,gimeracil and oteracil potassium combined with oxaliplatin has a significant clinical effect on advanced gastric cancer,which can effectively reduce serum CEA,CA19-9,CK18,CK19 levels,improve patient’s physical function and reduce the occurrence of adverse reactions.