替吉奥联合塞来昔布治疗晚期胃癌疗效观察

Therapeutic effect of tegafur,gimeracil and oteracil capsule combined with celecoxib on patients with advanced gastric cancer

目的评价替吉奥联合塞来昔布治疗晚期胃癌的疗效、不良反应,以及其对血管内皮生长因子（VEGF）和免疫功能的影响。方法 93例晚期胃癌患者随机分为2组,观察组48例接受替吉奥联合塞来昔布治疗,对照组45例接受单药替吉奥治疗。比较2组患者疗效、不良反应、VEGF水平及免疫功能。结果观察组和对照组患者治疗有效率分别为29.2%和26.7%,2组比较差异无统计学意义（P〉0.05）。观察组患者疾病控制率（81.3%）显著高于对照组（68.9%）（P〈0.05）。观察组患者临床受益率（83.3%）显著高于对照组（55.6%）（P〈0.05）。2组患者常见不良反应为骨髓抑制、恶心和呕吐、腹泻、乏力、色素沉着、皮疹等,多为Ⅰ~Ⅱ级,不良反应发生率比较差异无统计学意义（P〉0.05）。观察组患者化学治疗后VEGF水平治疗前和对照组治疗后（P〈0.05）。2组患者化学治疗后CD3＋、CD4＋、CD4＋/CD8＋水平均较化学治疗前显著升高（P〈0.05）,且化学治疗后观察组患者显著高于对照组（P〈0.05）。结论替吉奥联合塞来昔布治疗晚期胃癌安全、有效,并可改善患者机体免疫功能,且患者耐受性良好。

Objective To evaluate the therapeutic effect,adverse reaction,the influence on vascular endothelial growth factor（ VEGF） and immune function of tegafur,gimeracil and oteracil（ S1） capsule combined with celecoxib in the treatment on patients with advanced gastric cancer. Methods A total of 93 patients with advanced gastric cancer were randomly divided into two groups,48 cases in observation group were given S1 capsule combined with celecoxib,and 45 patients in control group were given single S1 capsule. The therapeutic effect,adverse reaction,the VEGF level and immune function of the two groups were compared. Results The response rate of the observation group and the control group was 29. 2% and 26. 7%,respectively,and the difference was not statistically significant（ P 0. 05）. The disease control rate in observation group（ 81. 3%）was significantly higher than that in control group（68. 9%）（ P 0. 05）. Clinical benefit rate in observation group（ 83. 3%）was statistically higher than that in control group（55. 6%）（ P 0. 05）. The major common adverse reactions were myelosuppression,nausea and vomiting,diarrhea,fatigue,pigmentation,skin rash. These adverse reactions were mostly ranked as Ⅰ- Ⅱlevel of adverse reaction,and there was no significant difference of the adverse reaction rate between the two groups（ P 0. 05）. The VEGF level of study group after treatment was significantly reduced（ P 0. 05）,and the VEGF level of study group was significantly lower than that of control group after treatment（ P 0. 05）. CD3＋,CD4＋,CD4＋/ CD8＋levels were significantly increased after treatment in the two groups（ P 0. 05）,which were significantly higher in the observation group compared with those in control group（ P 0. 05）. Conclusion S1 capsule combined with celecoxib treatment on patients with advanced gastric cancer is safe and effective,which can both improve immune function and retain favorable tolerance.