卡培他滨联合奥沙利铂治疗晚期食管胃交界部腺癌的临床研究

Clinical trial of capecitabine combined with oxaliplatin in the treatment of advanced oesphago-gastric junction adenocarcinoma

目的观察卡培他滨联合奥沙利铂治疗晚期食管胃交界部腺癌的临床疗效及安全性。方法将80例晚期食管胃交界部腺癌患者随机分为对照组40例和试验组40例。对照组给予静脉滴注75 mg·m^(-2)多西他赛,第1天+静脉滴注20 mg·m^(-2)顺铂,第1天+750 mg·m^(-2)氟尿嘧啶,从第1天起,持续输注120h;试验组给予静脉滴注120 mg·m^(-2)奥沙利铂,qd(用药2周后停药1周)+静脉滴注7.5 mg·kg^(-1)重组人血管内皮抑制素,qd+口服2000 mg·m^(-2)卡培他滨,bid(用药2周后停药1周)。2组患者一个周期均为21 d,共治疗3个周期。比较2组患者的临床疗效、血清肿瘤特异性大分子糖蛋白抗原19-9(CA199)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)、细胞跨膜Notch配体4(DLL4)水平以及不良反应发生率。结果治疗后,试验组的总有效率为90.00%显著高于对照组的72.50%(P<0.05)。治疗后,2组患者的CA199、CEA、VEGF、DLL4水平均显著低于治疗前(P<0.05),且试验组治疗后上述指标的水平明显低于对照组(P<0.05)。试验组的不良反应发生率为15.00%明显低于对照组的32.50%(P<0.05)。结论卡培他滨联合奥沙利铂治疗晚期食管胃交界部腺癌的临床疗效确切,且能显著降低患者血清CA199、CEA、VEGF和DLL4水平,且不良反应发生率较低。

Objective To evaluate the clinical efficacy and safety of capecitabine combined with oxaliplatin in the treatment of advanced esophago- gastric junction adenocarcinoma. Methods Eighty patients with advanced esophago - gastric junction adenocarcinoma were random- ly divided into control group （ n = 40 ） and treatment group （ n = 40 ）. Control group was treated with 75 mg. m-2 docetaxel, intravenous infu- sion, day 1 ＋ 20 mg . m-2 cisplatin , intravenous infusion, day 1 ＋ 750 mg .m-2 5 - fluorouracil, continuous infusion for 120 h, from day 1. Treatment group was received 120 mg. m-2 oxaliplatin, intravenous infusion, qd （after 2 weeks treatment, discontinuation 1 week） ＋ 7.5 mg . kg-1recombinant human endostatin, intravenous infusion, qd ＋ 2000 mg . m-2 capecitabine, oral, bid（after 2 weeks treatment, discontinuation 1 week）. Two groups were received 3 courses of treatment, 21 d for a course. The clinical efficacy cular glycoprotein antigen 19 -9 , levels of tumor specific macromole- （CA199）, cancer embryo antigen （CEA）, vascular endothelial growth factor （VEGF） and cell transmembrane notch ligand g （DLIA）, and the inci- dence of adverse drug reactions were compared between two groups. Resets After treatment, the total effective rate in treatment group was significantly higher than that in control group （90. 00% vs 72. 50%, P 〈 0. 05 ）. The levels of CA199, CEA, VEGF, DLIA after treatment in two groups were significantly lower than those before treatment （P 〈 0. 05）, and after treatment, these indexes in treatment group were lower than those in control group with signifi- cant difference （P 〈 0. 05 ）. The incidence of adverse drug reactions in treatment was lower than that in control group with significant difference （ 15.00% vs 32. 50%, P 〈 0. 05 ）. Conclusion Capecitabine combined with oxaliplatin have a definitive clinical efficacy and safety for the treatment of advanced esophago - gastric junction ad which can significantly reduce the levels of CA199, CEA, VEGF and DLL4.