芪竹方联合FOLFOX4方案治疗化疗失败的晚期胃癌患者22例临床观察

Clinical Observation on 22 Cases of Advanced Gastric Cancer with Chemotherapy Failure Treated with Combined Qizhu Formula and FOLFOX4

目的观察芪竹方联合FOLFOX4方案治疗一线化疗失败的晚期胃癌患者的有效性及安全性。方法将44例一线化疗失败的晚期胃癌患者随机分为治疗组和对照组各22例。治疗组给予芪竹方口服,每日1剂,同时联合FOLFOX4方案化疗;对照组单纯给予FOLFOX4方案化疗。治疗直至病情进展,或出现不能耐受的毒性,或患者拒绝接受化疗。比较两组患者临床证候改善情况、生存质量、肿瘤反应情况、无进展生存期(PFS)、总生存期(OS)、不良反应以及P-糖蛋白(Pg-p)、谷胱甘肽S-转移酶(GST-π)、拓扑异构酶Ⅱ(Topo-Ⅱ)表达情况。结果治疗组临床证候改善情况、PFS、OS均明显优于对照组(P<0.05或P<0.01)。治疗组治疗后Pg-p、GST-π、Topo-Ⅱ的表达例数均无明显变化(P>0.05);对照组治疗后Pgp、Topo-Ⅱ无明显变化(P>0.05),但GST-π表达例数明显高于治疗前(P<0.05)。结论芪竹方联合FOLFOX4治疗一线化疗失败的晚期胃癌有增效减毒作用,稳定GST-π的表达可能为其增效原因之一。

Objective To observe the efficacy and safety of combined treatment of Qizhu Formula and FOLFOX4 on advanced gastric cancer patients after failure of first-line chemotherapy. Methods Totally 44 patients with advanced gastric cancer who failed first-line chemotherapy were divided randomly into treatment group and control group, each with 22 patients. Treatment group was given Qizhu Formula orally, 1 dose per day, with FOLFOX4 chemotherapy, whereas control group was merely given FOLFOX4 chemotherapy. The treatments were continuously applied unless progression, or untolerable toxicity, or patients＂ rejection of chemotherapy occured. Improvement of clinical symptoms, quality of life, tumor response, progression free survival （ PFS）, overall survival （ OS）, adverse effects and the expression of P-glycoprotein （Pg-p）, glutathione S-transferase （GST-w）, topoisomerase lI （Topo- 11 ） of two groups were compared. Results Improvement of clinical symptoms, PFS, OS in the treatment group was notedly better than that in the control group （P 〈 0. 05 or P 〈 0. 01 ）. The expression of Pg-p, GST-w, Topo- U in treatment group showed no obvious change after treatments （P 〉 0. 05 ）. The expression of Pg-p ,＂ Topo- 11 in con- trol group also showed no obvious change after treatments （P 〉 0. 05 ）, but the expression of GST-π after treatments was observably higher than before （P 〈 0. 05）. Conclusion Combined treatment of Qizhu Formula and FOLFOX4 on advanced gastric cancer patients who failed first-line chemotherapy has the effect of enhancing efficacy and reduc- ing toxicity. Stabilizing the expression of GST-π may be one of the reasons of its efficacy-enhancing effect.