沙利度胺联合XELOX方案治疗晚期胃癌的临床研究

Clinical study on thalidomide combined with XELOX regimen in treatment of advanced gastric cancer

目的探讨沙利度胺联合XELOX方案(奥沙利铂+卡培他滨)治疗晚期胃癌的临床疗效。方法选取2013年1月—2016年1月丹阳市人民医院收治晚期胃癌患者180例,随机分为对照组和治疗组,每组各90例。对照组患者静脉滴注注射用奥沙利铂,130 mg/m2,1次/14 d,同时口服卡培他滨片,每次1 250 mg/m2,2次/d,持续治疗14 d。治疗组在对照组基础上睡前口服沙利度胺片,200 mg/次,1次/d,14 d为1个疗程,连续治疗2个疗程。观察两组患者临床疗效,同时比较治疗前后两组患者KPS评分及血管内皮生长因子(VEGF)、内皮细胞特异性分子-1(ESM-1)、神经纤毛蛋白-1(NRP-1)水平。结果治疗后,对照组客观缓解率为35.6%,显著低于治疗组的51.1%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者KPS评分显著升高(P<0.05),且治疗后治疗组KPS评分明显高于对照组(P<0.05)。治疗后,两组患者VEGF、ESM-1和NRP-1水平均显著降低(P<0.05),且治疗组血清VEGF、ESM-1和NRP-1水平明显低于对照组(P<0.05)。结论沙利度胺联合XELOX方案能够有效抑制肿瘤新生血管生成,降低血清ESM-1、NRP-1表达,具有一定的临床推广应用价值。

Objective To explore the clinical effect of thalidomide combined with XELOX regimen(oxaliplatin + capecitabine) in treatment of advanced gastric cancer. Methods Patients(180 cases) with advanced gastric cancer in Danyang People’s Hospital from January 2013 to January 2016 were randomly divided into control and treatment groups, and each group had 90 cases. Patients in the control group were iv administered with Oxaliplatin for injection, 130 mg/m^2, once every 14 d, and at the same time, they were po administered with Capecitabine Tablets, 1 250 mg/m^2, twice daily. Patients in the treatment group were po administered with Thalidomide Tablets on the basis of the control group, 200 mg/time, once daily, and 14 d was a course of treatment, and they were treated for 2 courses of treatment. After treatment, the clinical efficacy was evaluated, and the KPS scores, VEGF, ESM-1, and NRP-1 levels in two groups before and after treatment were compared. Results After treatment, the objective reaction rate in the control group was 35.6%, which was significantly lower than 51.1% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the KPS scores in two groups were significantly increased(P < 0.05), and the KPS scores in the treatment group were significantly higher than that in the control group(P < 0.05). After treatment, the serum VEGF, ESM-1, and NRP-1 levels in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Thalidomide combined with XELOX regimen can effectively inhibit tumor neovascularization, reduce serum ESM-1, NRP-1 expression, which has a certain clinical application value.