卡培他滨与奥沙利铂联合贝伐单抗方案治疗老年晚期胃癌疗效及安全性分析

Efficacy and safety evaluation of capecitabine combined with oxaliplatin plus bevacizumab in treatment of elderly patients with advanced gastric cancer

目的:探讨卡培他滨加奥沙利铂的XELOX方案联合贝伐单抗治疗对老年晚期胃癌患者的疗效、生存质量改善及安全性。方法:142例老年晚期胃癌患者随机分为对照组和观察组,各71例。对照组采用多西他赛(DXT)+顺铂(DDP)+氟尿嘧啶化疗方案;观察组采用卡培他滨(CAP)+奥沙利铂(L-OHP)+贝伐单抗化疗方案。比较两组治疗后中位进展时间和生存时间,血清肿瘤标志物CA199、CA242和癌胚抗原(CEA)变化,生活质量Spitzer指数变化及不良反应。结果:化疗后观察组CA199、CA242和CEA浓度显著低于化疗前和对照组化疗后水平(P<0.05);观察组中位疾病进展时间(TTP)和中位生存期(MST)分别为(6.1±2.9)和(11.3±3.7)个月,显著长于对照组[(4.2±1.8)个月和(8.0±2.0)个月](P<0.05);观察组Spitzer总评分为(39.8±1.7)分,显著高于对照组[(31.3±1.6)分](P<0.05);观察组白细胞、血小板和血红蛋白减少,胃肠道反应及肝肾功能异常的发生率均显著低于对照组(P<0.05)。结论:CAP与L-OHP联合贝伐单抗方案能显著降低老年晚期胃癌血清肿瘤标志物浓度,延长患者生存时间,提高患者化疗后生活质量,且不良反应少,综合疗效显著。

Objective： To investigate the effect of capeeitabine combined with oxaliplatin plus bevacizumab on quality of life and its safety in the treatment of elderly patients with advanced gastric cancer. Methods： A total of 142 elderly patients with advanced cancer were randomly divided into the control groups and the observation groups, with 71 cases in each group. Patients in control groups were treated with docetaxel （DXT） ＋ cisplatin （DDP） ＋ fluorouracil chemotherapy while patients in observation groups were treated with capecitabine （CAP） ＋ Asha Leigh Per （L OHP） ＋bevacizumab. The median time to progression and survival time, level changes of serum tumor markers CA199, CA242 and CEA, Spitzer index changes in the quality of life and adverse reaction of two groups after treatment were compared. Results： The level of CA199, CA242 and CEA in the observation groups were significantly lower than that of before chemotherapy and the control groups （P〈0.05）. TTP and MST time of the observation groups were （6.1 4± 2.9） and （11.3 ±3.7） mouths, significantly longer than that of the control groups （4.24±1.8） and （8.0±2.0） months （P〈0.05）. The Spitzer total score in the observation groups were 39. 8 4±1.7, significantly higher than that of the control groups （31.3 ± 1.6） （P〈0.05）. The rate of white blood cell, plateletand hemoglobin decreased, liver and kidney function of gastrointestinal tract reaction and the abnormality in the observation groups were all significantly lower than those of the control groups （P〈 0.05）. Conclusions： CAP and L-OHP plus bevaci- zumab could significantly reduce the concentration of gastric tumor markers in serum, prolong the survival time and improved the quality of life in the elderly patients with advanced and less adverse reaction.