塞来昔布联合化疗对腹腔镜胃癌根治术患者的临床疗效

Clinical application of celecoxib combined with FOLFOX4 chemotherapy after Radical Operation of Gastric Carcinoma

目的:评价塞来昔布联合FOLFOX4化疗方案对腹腔镜胃癌根治术患者的疗效和安全性。方法:将已行腹腔镜胃癌根治术患者50例随机分为观察组和对照组,每组各25例。对照组行常规FOLFOX4方案化疗,21d为1个周期,共6个周期;观察组在常规化疗基础上给予口服塞来昔布400 mg,2次/d。收集术前、术后3周(化疗前)及治疗6个周期后的血清标本,采用酶联免疫吸附试验检测血清VEGF和COX-2水平。结果:50例患者均按期完成治疗,两组患者有效率、临床获益率及生活质量比较差异有统计学意义(P<0.05);不良反应比较差异无统计学意义(P>0.05);术前及术后3周(化疗前)观察组和对照组患者血清VEGF和COX-2表达差异无统计学意义(P>0.05);治疗6个周期后观察组血清VEGF和COX-2水平明显低于对照组(P<0.01),且均较化疗前显著下降(P<0.01)。结论:塞来昔布联合FOLFOX4方案治疗胃癌根治术后患者效果较单用化疗方案好,能提高有效率、临床获益率及生活质量,且耐受性良好,能够降低血清VEGF和COX-2的表达水平,抑制肿瘤血管新生,有助于减少复发转移。

Objective：To evaluate the treatment efficacy、safety and quality of life after application of FOLFOX4 chemotherapy combined with celecoxib in laparoscopic radical gastrectomy for advanced gastric cancer,and study the Expression of cyclooxygenase-2 and vascular endothelial growth factor after the application of celecoxib combined with FOLFOX4 chemotherapy in post gastrectomy.Methods：50 patients after laparoscopic gastric cancer radical operation were randomly divided into two groups：observation group （n=25） and control group （n=25）.The control group treated with FOLFOX4 chemotherapy,days apart to each cyce,al patients received 6 cycles,while patients of observation group were added oral celecoxib（400mg,bid） on the basement treatment.Levels of serum VEGF and COX-2 were measured by enzyme-linked immunosorbent assay （ELISA）before operation and after 3 weeks and 6 treatment cycies after operation.Results：All 50 patients completed the treatment on schedule.Significant difference was found in the response rate （CR＋PR）,the ciinical beneficial response and quality of life between the two groups（P＜0 05）; Incidences of adverse effect showed no significant difference between the two groups （P ＞ 0.05）.The level of serum VEGF and COX-2 before operation and 3 weeks after operation had no statistical significant between the two groups（P＞0.05）.In both groups the levels of VEGF and COX-2 were much lower than that before therapy （P＜0.01）.After 6 cycles,treatment,the levels of VEGF and COX-2 of the treatment group were much lower than that of the control group （P＜0.05）.The obvious correlation canbe seen between the expressions of VEGF and COX-2 in gastric carcinoma.Conclusion：FOLFOX4 chemotherapy combined with celecoxib can improve the efficiency,the clinical benefit rate and quality of life,and well tolerated,it can down-regulates the express on of VEGF and COX-2 in gastric cancer,suppress angiogenesis in tumor tissue and can prevent and therapy for metastasis and recurrence of gastric cancer,but the long term efficiency should be further followed-up and Widely application.