帕洛诺司琼联合FOLFOX4化疗方案对胃癌根治术后患者胃肠道反应的影响

Effect of palonosetron combined with FOLFOX4 chemotherapy on gastrointestinal reaction in gastric cancer patients after radical gastrectomy

目的探讨帕洛诺司琼联合FOLFOX4化疗方案对胃癌根治术后患者胃肠道反应的影响。方法选取2014年3月至2017年3月延安大学附属医院收治的胃癌根治术后患者100例,依据随机数字表法分为观察组和对照组,各50例,对照组给予地塞米松联合FOLFOX4化疗方案治疗,观察组在对照组基础上给予帕洛诺司琼治疗,比较2组患者化疗前后血清胃动素和胃泌素水平、胃肠道反应、其他不良反应以及化疗有效率的差异。结果本研究100例患者中16例由于化疗中断而终止研究,入选观察组、对照组各42例。化疗前,2组患者的血清胃动素、胃泌素水平比较差异均无统计学意义(均P>0.05)。化疗后,2组血清胃动素水平明显低于化疗前、且观察组低于对照组[(83±8)ng/L比(92±9)ng/L],血清胃泌素水平明显高于化疗前、且观察组高于对照组[(330±88)μg/L比(283±72)μg/L],差异均有统计学意义(均P<0.05);观察组急性恶心、延迟性恶心、急性呕吐、延迟性呕吐控制有效率明显高于对照组[90.5%(38/42)比59.5%(25/42)、83.3%(35/42)比50.0%(21/42)、85.7%(36/42)比57.1%(24/42)、81.0%(34/42)比52.4%(22/42)],差异均有统计学意义(均P<0.05)。2组其他不良反应发生率、化疗有效率比较差异均无统计学意义(均P>0.05)。结论帕洛诺司琼联合FOLFOX4化疗方案可有效改善胃癌根治术后患者血清胃动素、胃泌素水平,有利于减轻胃肠道反应。

Objective To explore the effect of palonosetron combined with FOLFOX4 chemotherapy on gastrointestinal reaction in gastric cancer patients after radical gastrectomy. Methods A total of 100 patients with gastric cancer who had radical gastrectomy from March 2014 and March 2017 in Yan′an University Affiliated Hospital were randomly divided into observation group and control group, with 50 cases in each group. The control group was treated with dexamethasone combined with FOLFOX4 chemotherapy; the observation group was treated with palonosetron on the basis of control group. Serum levels of motilin and gastrin, occurrences of gastrointestinal reactions and other adverse reactions and efficacy of chemotherapy were analyzed. Results Sixteen patients were withdrawn from the test. Serum levels of motilin and gastrin had no significant differences between observation group（n＝42） and control group（n＝42） before chemotherapy（P＞0.05）. After chemotherapy, serum level of motilin significantly decreased compared to that before chemotherapy in both groups; serum level of motilin in observation group was significantly lower than that in control group［（83±8）ng/L vs （92±9）ng/L］（P〈0.05）. After chemotherapy, serum level of gastrin significantly increased compared to that before chemotherapy in both groups; serum level of gastrin in observation group was significantly higher than that in control group［（330±88）μg/L vs （283±72）μg/L］（P〈0.05）. Effective control rates of acute nausea, delayed nausea, acute vomiting, delayed vomiting in observation group were significantly higher than those in control group［90.5%（38/42） vs 59.5%（25/42）, 83.3%（35/42） vs 50.0%（21/42）, 85.7%（36/42） vs 57.1%（24/42）, 81.0%（34/42） vs 52.4%（22/42）］（P〈0.05）. Incidence of non-gastrointestinal reactions and effective rate of chemotherapy showed no significant differences between groups（P〉0.05）. Conclusion Palonosetron combined with FOLFOX4 chemotherapy treating postoperative gastric cancer patients can effectively improve serum levels of motilin and gastrin and reduce gastrointestinal reactions.