曲妥珠单抗联合奥沙利铂治疗人类表皮生长因子受体2阳性胃癌患者的临床效果

Clinical effect of trastuzumab combined with oxaliplatin on human epidermal growth factor receptor-2-positive gastric cancer

目的观察曲妥珠单抗联合奥沙利铂治疗人类表皮生长因子受体2(HER2)阳性胃癌患者的临床效果。方法选取2011年3月至2014年9月在陕西省延安市人民医院接受治疗的242例HER2阳性胃癌患者。按照随机数字表法将患者分为曲妥珠单抗组(78例)、奥沙利铂组(82例)和联合组(82例),分别给予相应药物静脉注射连续治疗18周。比较3组患者的治疗总反应率、临床有效率、无进展生存期、总生存期和不良反应发生率。结果联合组的治疗总反应率、临床有效率高于曲妥珠单抗组和奥沙利铂组[73.2%(60/82)比48.7%(38/78)、42.7%(35/82),45.1%(37/82)比30.8%(24/78)、26.8%(22/82)](P<0.01或P<0.05)。联合组的无进展生存期和总生存期明显长于曲妥珠单抗组和奥沙利铂组,不良反应发生率明显低于曲妥珠单抗组和奥沙利铂组[67.1%(55/82)比91.0%(71/78)、92.7%(76/82)](均P<0.05)。结论曲妥珠单抗联合奥沙利铂治疗HER2阳性胃癌患者临床效果较好。

Objective To observe the clinical effect of trastuzumab combined with oxaliplatin on human epidermal growth factor receptor-2 （HER2）-positive gastric cancer. Methods Totally 242 patients with HER2- positive gastric cancer in Yan＇an People＇s Hospital, Shaanxi Province from March 201i to September 2014 were randomly divided into trastuzumab group （78 cases ）, oxaliplatin group （82 cases ） and combination group （82 cases） ; all patients had intravenous injection of corresponding drugs for 18 weeks. Total response rate, clinical effective rate, progression free survival time, overall survival time and adverse reactions were analyzed. Results Total response rate and clinical effective rate in combination group were significantly higher than those in trastuzumab group and oxaliplatin group[73.2% （60/82） vs 48.7% （38/78）, 42. 7% （35/82） ; 45.1% （37/82） vs 30. 8% （ 24/78 ） , 26, 8% （22/82） ] （ P 〈 0. 01 or P 〈 0. 05 ）. Progression free survival time and overall survival time in combination group were significantly longer than those in trastuzumab group and oxaliplatin group; incidence of adverse effects in combination group was significantly lower than that in trastuzumab group and oxaliplatin group[67. 1% （55/82） vs 91.0% （71/78）, 92. 7% （76/82） ] （P 〈0. 05）. Conclusion Trastuzumab combined with oxaliplatin has a good clinical therapeutic effect on HER2-positive gastric cancer.