伊立替康联合顺铂、5-FU治疗晚期胃癌的效果观察

Efficacy of irinotecan combined with cisplatin and fluorouracil for advanced gastric cancer

目的探讨伊立替康联合顺铂、氟尿嘧啶(5-FU)治疗晚期胃癌的效果。方法选取2010年1月-2016年12月重庆市某医院收治的104例晚期胃癌患者作为研究对象,利用随机数字表分为实验组和对照组,每组52例。对照组患者采用顺铂、5-FU进行治疗,实验组患者在对照组基础上联用伊立替康进行治疗,比较2组患者的疗效、不良反应发生情况及预后。结果实验组患者治疗总有效率、疾病控制率分别为50.00%和84.62%,高于对照组的30.76%和65.38%,差异均有统计学意义(P<0.05)。实验组患者白细胞减少、血小板减少、腹泻、肝功能异常发生率分别为80.77%,34.62%,30.77%及44.23%,均高于对照组的42.31%,9.62%,7.69%及23.08%,差异均有统计学意义(P<0.05)。实验组患者总生存时间(OS)为3~28个月,中位OS为21个月;对照组患者OS为3~23个月,中位OS为16个月。实验组患者OS长于对照组,差异有统计学意义(P<0.05)。结论伊立替康联合顺铂、5-FU治疗晚期胃癌疗效较好,可改善患者预后,但容易导致患者发生白细胞减少、血小板减少、腹泻、肝功能异常等不良反应,因此在治疗时需严密监测不良反应。

Objective To investigate the efficacy of irinotecan combined with cisplatin and fluorouracil（5-FU）for advanced gastric cancer.Methods From January 2010 to December 2016,104 patients with advanced gastric cancer admitted in a hospital in Chongqing were selected as the research objects and divided into experimental group and control group using the random number table,52 cases in each group.In control group patients treated with cisplatin and 5-FU,while in the experimental group patients were treated with irinotecan plus the treatment of the control group.The efficacy,adverse reactions and prognosis of two groups＇treatments were compared.Results The total effective rate and disease control rate of experimental group were50.00% and 84.62% respectively,which were higher than 30.76% and 65.38% of control group,and the difference had statistical significance（P〈0.05）.The incidence of leukopenia,thrombocytopenia,diarrhea and abnormal liver function of experimetal group were 80.77%,34.62%,30.77% and 44.23%,and they were higher than 42.31%,9.62%,7.69% and 23.08% of control group,and the difference had statistical significance（P〈0.05）.The overall survival（OS）of patients in experimental group was 3-28months,and the median OS was 21months;In control group patients＇OS was 3-23months,and the median OS was 16 months.The experimental group patients＇OS was longer than the control group,and the difference was statistically significant（P〈0.05）.Conclusion The combination of irinotecan,cisplatin and 5-FU for advanced gastric cancer is effective obviously and it can improve the prognosis of patients,it is also easy to cause adverse reactions like leukopenia,thrombocytopenia,diarrhea and abnormal liver function,so monitoring adverse reactions closelyis required in the treatment.