XELOX方案治疗进展期老年胃癌患者对血清胃蛋白酶原及GAS-17的影响

Effect of XELOX regimen in the treatment of advanced gastric cancer in elderly patients and the influence on PG and GAS-17

目的研究XELOX方案对进展期老年胃癌患者的临床疗效以及对血清胃蛋白酶原(PG)和胃泌素-17(GAS-17)的影响。方法对107例进展期老年胃癌患者进行卡培他滨联合奥沙利铂(XELOX方案)化疗,于治疗3个周期后评价临床疗效和不良反应,并比较血清PGⅠ、PGⅡ、PGR以及GAS-17水平变化。结果 107例患者第1个至第3个化疗周期的总有效率分别为25.23%、35.51%、47.66%,差异有统计学意义(P﹤0.05),第3个化疗周期结束后总有效率高于第1个周期(P﹤0.05)。白细胞降低、恶心呕吐、积蓄性和可逆性神经毒性、手足综合征1级不良反应发生率分别为33.64%、35.51%、36.45%、32.71%,其他不良反应发生率较低,所有患者均可耐受。随着化疗周期延长,患者的PGⅠ、PGR指标呈上升趋势,PGⅡ和GAS-17水平呈下降趋势,差异有统计学意义(P﹤0.05)。结论 XELOX方案治疗进展期老年胃癌切实有效,患者耐受性良好,安全性良好,且治疗后患者胃黏膜功能得以一定程度恢复,能有效升高PG水平,同时降低GAS-17水平,值得临床推广。

Objective To analyze the effect of XELOX regimen in the treatment of advanced gastric cancer in elderly patients and the influence on PG and GAS-17. Method 107 cases of elderly advanced gastric cancer patients were treated with capecitabine plus oxaliplatin（XELOX） regimen. After 3 cycles of treatment, the clinical effect and adverse reactions were analyzed, the PGI, PGII and PGR, as well as GAS-17 levels before and after each course of treatment were compared. Result The overall response rate after the 1 st, 2 nd, and 3 rdcourse was 25.23%, 35.51%, and 47.66%, respectively, which showed significant difference（P〈0.05）, and that in the 3 rdcourse was higher than 1 stcourse（P〈0.05）. The incidence of leukocytopenia, nausea and vomiting, accumulative and reversible neurotoxicity, hand-foot syndrome were33.64%, 35.51%, 36.45%, and 32.71%, respectively, other adverse effects were less common, and all were tolerated. With the increase of chemotherapy cycle, PGI and PGR were increasing, while PGII and GAS-17 levels were decreased, the difference was statistically significant（P〈0.05）. Conclusion XELOX regimen can improve the clinical effect in the treatment of advanced gastric cancer in the elderlies, with acceptable tolerance and safety, and meanwhile, it can effectively increase the PG level, and decrease the level of GAS-17, which may help recover the function of gastric mucosa.