吉西他滨、氟尿嘧啶、亚叶酸钙联合治疗老年晚期食管癌临床疗效及其对血清胰岛素样生长因子-1和转化生长因子-β_1的影响

Clinical effect of treating elderly advanced esophageal carcinoma by Gemcitabine,Fluorouracil and Leucovorin and its influence on serum insulin-like growth factor-1 and transforming growth factor-beta 1

目的探讨由吉西他滨(GEM)、氟尿嘧啶(5-FU)、亚叶酸钙(LV)组成的GLF联合化疗方案治疗老年晚期食管癌的临床疗效及其对患者血清胰岛素样生长因子-1(IGF-1)及转化生长因子-β1(TGF-β1)的影响。方法选取老年食管癌患者68例为研究对象,行锁骨下静脉穿刺或经外周静脉穿刺中心静脉置管,予以GLF方案,检测患者血清IGF-1及TGF-β1水平,评价疗效,记录无进展生存期(PFS)与总生存期(OS)及治疗过程中的不良反应。结果患者治疗2～6个周期后,客观缓解率为54.41%,疾病控制率为76.47%,中位PFS为6.2个月,中位OS为10.5个月,不良反应发生率为14.71%。治疗后血清IGF-1及TGF-β1水平均明显降低,差异具有高度统计学意义(P<0.01)。结论 GLF联合化疗方案治疗老年晚期食管癌具有较好临床效果,抑制了血清IGF-1及TGF-β1的活性,在提高患者生存质量、延长生存期方面具有较好的作用,且具有较高的安全性,比较适合于老年晚期食管癌的临床治疗。

Objective To explore the clinical effect of treating elderly advanced esophageal carcinoma by Gemcitabine（GEM）,fluorouracil（5-FU）,and leucovorin（LV） and its influence on serum insulin-like growth factor-1（IGF-1） and transforming growth factor-beta 1（TGF-β 1）.Methods 68 elderly cases with advanced esophageal carcinoma were selected as research object,punctured through subclavian vein or inserted central venous catheter by peripheral vein,and given GEM, 5-FU and LV.Then,serum IGF-1 and TGF-β 1 were tested,clinical effect were evaluated,and progression-free survival（PFS）,overall survival and adverse reaction were recorded.Results Patients were treated with 2-6 cycles,the objective response rate was 54.41%,disease control rate was 76.47%,median PFS was 6.2 months,median OS was 10.5 months,and adverse reactions incidence was 14.71%.After treatment,serum IGF-1 and TGF-β 1 level were significantly decreased,and there were significant difference（P0.01）.Conclusion It has good clinical effect of treating elderly advanced esophageal carcinoma by GEM,5-FU and LV,inhibits serum IGF-1 and TGF-β 1 activity,has better function on improving patients＇s living quality and prolonging survival time,also with high security,so it is more suitable to elderly advanced esophageal carcinoma＇s clinical treatment.