生长抑素联合多西他赛和替吉奥治疗进展期胃癌的临床研究

Clinical study of somatostatin combined with docetaxel and Tegafur in treatment of advanced gastric cancer

目的探讨注射用生长抑素联合多西他赛注射液和替吉奥胶囊治疗进展期胃癌的临床疗效。方法抽取中国人民解放军第八六医院2013年1月—2015年12月收治的胃癌患者86例,随机数字表格法将患者分为对照组和治疗组,每组各43例。对照组第1天静脉滴注多西他赛注射液75 mg/m2;口服替吉奥胶囊60 mg/m2,2次/d,于早饭后和晚饭后服用,连服21 d,之后停药14 d,作为1个周期,干预2个周期。治疗组在对照组基础上第1~5天微泵注射用生长抑素3 mg,持续6 h,2次/d,连续21 d,作为1个周期,干预2个周期。观察两组的临床疗效,比较两组治疗前后肿瘤标志物和血管内皮生长因子水平以及毒副反应情况。结果治疗后,对照组、治疗组的近期有效率分别为69.77%、88.37%,两组近期有效率比较差异有统计学意义(P<0.05)。治疗后,两组CA199、CEA、CA724水平均明显降低,同组治疗前后差异有统计学意义(P<0.05);治疗组CA199、CA724水平降低程度明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组血清VEGF-A、VEGF-C、VEGF-D水平均明显下降,同组治疗前后差异有统计学意义(P<0.05);治疗组这些观察指标的降低程度明显低于对照组,两组比较差异具有统计学意义(P<0.05)。两组患者血小板减少、中性粒细胞减少、恶心呕吐、肝损伤、腹泻不良反应发生率比较差异无统计学意义。结论注射用生长抑素联合多西他赛注射液和替吉奥胶囊治疗进展期胃癌具有较好的临床疗效,明显降低肿瘤标志物、血清血管内皮生长因子水平,减少不良反应,具有一定的临床推广应用价值。

Objective To analyze the clinical effect of Somatostatin for injection combined with Docetaxel Injection and Tegafur Capsules in treatment of advanced gastric cancer. Methods Patients （86 cases） with advanced gastric cancer in No. 86 Hospital of PLA from January 2013 to December 2015 were divided into the control and treatment groups by random number table, and each group had 43 cases. The patients in the control group were iv administered with Docetaxel Injection in the first day, 75 mg/m2. And they werepo administered with Tegafur Capsules after breakfast and after dinner, 60 mg/m2, twice daily, and treated for 21 d, then were repeated the next course of treatment after 4 d rest. The patients in the treatment group were micropump administered with Somatostatin for injection on the basis of the control group, 3 mg for 6 h, twice daily, 21 d for a course of treatment. The patients in two groups were treated for two courses. After treatment, clinical efficacy was evaluated, and tumor marker levels, serum VEGF levels and adverse reactions in two groups before and after treatment were compared. Results After treatment, the short-term efficacies in the control and treatment groups were 69.77% and 88.37%, respectively, and there was significant difference between groups （P 〈 0.05）. After treatment, the levels of CA199, CEA, CA724, serum VEGF-A, VEGF-C and VEGF-D were significantly decreased, and the differences were statistically significant in the same group （P 〈 0.05）. After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）. There wereno significant on adverse reaction rates of thrombocytopenia, thrombocytopenia, nausea and vomiting, liver injury, and diarrhea between two groups. Conclusion Somatostatin for injection combined with Docetaxel Injection and Tegafur Capsules has a significant clinical efficacy in treatment of advanced gastric cancer, can decrease tumor marker levels, serum VEGF levels, and reduce adverse reaction, which has a certain clinical application value.