经动脉灌注化疗联合SOX全身化疗方案治疗进展期胃癌的临床效果研究

Arterial Perfusion Combined with SOX Systemic Chemotherapy Regimens to Treat Advanced Gastric Cancer

目的探讨经动脉灌注化疗(介入治疗)联合SOX全身化疗方案治疗进展期胃癌(AGC)的临床疗效和安全性。方法选取2008年1月—2009年12月青海大学附属医院肿瘤科收治的初诊为AGC的患者86例,按随机数字表法分为对照组和观察组各43例,对照组患者接受单纯SOX全身化疗方案,观察组患者接受介入治疗联合SOX全身化疗方案,21 d为1个周期,按照WHO实体瘤的疗效评价标准(RECIST)评价近期临床疗效,按照WHO抗肿瘤治疗毒副作用标准进行毒副作用评价。从术后第1个月开始每个月进行门诊随访或电话随访直至患者去世,比较两组患者的生存曲线,评价远期临床疗效。结果观察组和对照组患者的治疗有效率分别为76.7%(33/43)和53.5%(23/43),差异有统计学意义(χ2=5.119,P<0.05)。两组患者毒副作用发生率比较,差异均无统计学意义(P>0.05)。两组患者的中位总生存时间分别为300.0 d和377.5 d,两组生存曲线比较,差异有统计学意义(χ2=7.118,P=0.007)。结论介入治疗联合SOX全身化疗方案的近期临床疗效和远期临床疗效均优于单纯SOX全身化疗方案,并且安全性与之相当,值得临床推荐。

Objective To explore the clinical efficacy and safety of arterial perfusion（ AP） combined with SOX systemic chemotherapy regimens（ SOX- SCR） for advanced gastric cancer（ AGC）. Methods A total of 86 AGC patients admitted to the Oncology Department of the Affiliated Hospital of Qinghai University from January 2008 to December 2009 were divided randomly into groups control and study,43 in each. The control group were given simple SOX- SCR,the study group given AP combined with SOX- SCR,21 d as a course. Evaluated the short- term clinical effects according to WHO＇s Response Evaluation Criteria in Solid Tumors（ RECIST） and the adverse reactions according to WHO＇ s Criteria for Adverse Reactions of Antineoplaston. Given clinical or telephone follow- ups every month from month 1 after operation till patients＇ death,compared the survival curves between the two groups and evaluated the long- term clinical effects. Results The effective rate was 76. 7%（ 33 /43） in study group,53. 5%（ 23 /43） in control group,the difference was significant（ χ^2= 5. 119, P〉0. 05）. No difference was noted in adverse reactions between the two groups（ P〉0. 05）. The median overall survival time was 300. 0 d in control group,377. 5 d in study group,and there was difference in survival curve（ χ^2= 7. 118,P = 0. 007）. Conclusion AP combined with SOX- SCR,superior to simple SOX- SCR in short- term and long- term clinical effects with corresponding safety,is worthy of recommendation in clinic.