阿帕替尼与替吉奥联合治疗晚期胃癌疗效分析及对相关细胞因子的影响

Curative effect analysis and effect on cytokines of apatinib combined with S-1 in the treatment of advanced gastric cancer

[目的]探讨阿帕替尼与替吉奥联合治疗晚期胃癌疗效分析及对相关细胞因子的影响。[方法]选取2014年1月~2016年1月我院门诊收治的30例一线治疗失败的晚期胃癌患者,按随机分组法将所有患者分为观察组和对照组,每组各15例。对照组采用替吉奥治疗,观察组采用阿帕替尼与替吉奥联合治疗。比较2组患者治疗有效率、血清肿瘤标志物水平、Th1和Th1类细胞因子水平、不良反应发生率及生存情况。[结果]观察组患者的有效率和疾病控制率(46.7%、80.0%)均显著高于对照组(33.3%、66.7%),差异有统计学意义(P<0.05)。治疗后观察组患者血清CEA和CA199水平显著低于对照组(P<0.05)。观察组IFN-γ和TNF-α水平显著高于对照组,而IL-4和IL-10显著低于对照组,差异有统计学意义(P<0.05)。2组患者不良反应发生率差异无统计学意义(P>0.05)。观察组患者的平均进展时(5.2±0.7)均显著低于对照组(7.1±1.3),平均生存期(9.3±2.5)均显著高于对照组(5.1±1.3),差异有统计学意义(P<0.05)。[结论]阿帕替尼与替吉奥联合二线治疗晚期胃癌的疗效确切,可明显提高生存期,但不增加不良反应发生率,值得进一步研究。

[Objective]To investigate the curative effect of apatinib combined with S-1 in the treatment of advanced gastric cancer efficacy and the effect on cytokines.[Methods]30 patients with advanced gastric cancer treated in our hospital from January 2014 to January 2016 were selected,all patients were randomly divided into observation group（n=15）and control group（n=15）.The patients in the control group were received S-1 treatment,the patients in the observation group was treated with apatinib combined with S-1 treatment.The effective rate,serum tumor markers,the levels of Th1 and Th1 cytokines,incidence of adverse reactions and survival rate were respectiely compared between the two groups.[Results]The effective rate and disease control rate（46.7%,80%）in the observation group were significantly higher than those in the control group（33.3%,66.7%）（P〈0.05）.After treatment,the levels of serum CEA and CA199 in the observation group were significantly lower than those in the control group（P〈0.05）.The levels of IFN-γand TNF-αin the observation group were significantly higher than those in the control group,while IL-4 and IL-10 were significantly lower than those in the control group（P〈0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）.The mean time to progression（5.2±0.7）of the observation group were significantly higher than those of the control group（7.1±1.3）,the average survival time（9.3±2.5）of the observation group were significantly higher than those of the control group（5.1±1.3）（P〈0.05）.[Conclusion]The second-line treatment（apatinib plusS-1）of advanced gastric cancer is effective,which significantly improvd survival,but increased the incidence of adverse reactions.