沙利度胺联合一线化疗方案治疗胃癌krukenberg瘤血清VEGF水平变化与疗效相关性研究

EFFECT OF THALIDOMIDE COMBINED WITH FIRST-LINE CHEMOTHERAPY ON THE SERUM VEGF LEVEL IN THE TREATMENT OF GASTRIC CARCINOMA COMPLICATED WITH KRUKENBERG TUMOR

目的探讨沙利度胺联合一线化疗方案治疗胃癌krukenberg瘤血清血管内皮生长因子(VEGF)水平变化与疗效相关性及临床疗效。方法对我院2003年2月—2015年3月就诊治疗的76例胃癌krukenberg瘤患者的临床资料进行回顾性分析。对照组给予一线化疗方案治疗,观察组在对照组基础上联合沙利度胺治疗。比较二组患者近期疗效,随访1年、2年生存率,毒副反应发生情况及治疗前后的血清VEGF水平变化和疗效相关性。结果观察组的近期总有效率(RR:65.79%)、肿瘤控制率(DCR:68.42%)均高于对照组(42.11%)、(44.74%)(P<0.05);观察组的1年生存率(60.53%)、2年生存率(34.21%)均分别高于对照组(36.84%)、(13.16%)(P<0.05);治疗后二组患者血清VEGF水平均低于治疗前(P<0.05),且观察组低于对照组(P<0.05);胃癌krukenberg瘤患者治疗后血清VEGF水平下降幅度和治疗疗效呈正相关关系(r=0.675,P<0.05);观察组血小板减少、白细胞减少等方面毒副反应发生率低于对照组(P<0.05)。结论沙利度胺联合一线化疗方案治疗胃癌krukenberg瘤可提高患者近期疗效,延长患者生命时间,能有效地抑制血清VEGF水平,血清VEGF水平下降幅度越大其疗效越好,对于其治疗疗效有一定的评估意义。

Objective To investigate the effect of thalidomide combined with firstline chemotherapy on the serum VEGF level in the treatment of gastric carcinoma complicated with Krukenberg tumor.Methods The clinical data of 76 gastric carcinoma patients complicated with Krukenberg tumor treated in author＇s hospital from February 2003 to March 2015 were retrospectively analyzed.The patients were divided into two groups, each with 38 cases.The control group received firstline chemotherapy regimens, based on this, the observation group received the thalidomide.The short- term efficacy, 1 - year and 2 - year survival rates during fol- low- up period,incidence of toxic and side effect,and changes in serum VEGF levels and efficacy were com- pared between the two groups.Results The response rate and the tumor control rate were 65.79% and 68. 42% in the observation group, which were significantly higher than those in the control group （42.11%, 44.74% ,P〈0.05）.The 1 - year and 2 - year survival rates of the observation group were significantly higher than those of the control group （60.53% vs 36.84%,34.21% vs 13.16% ,P〈0.05）.The serum VEGF levels were decreased after treatment,and was lower in the observation group than in the control group （P〈0.05）. The decrease of serum VEGF levels was positively correlated with therapeutic efficacy after treatment （ r = 0.675,P〈0.05 ）. The incidence of side effects such as thrombocytopenia and leukopenia in the observation group was lower than that in the control group （P〈0.05）.Conelusion The shortterm efficacy of thalidomide combined with firstline chemotherapy in the treatment of gastric carcinoma complicated with Krukenberg tumor is significant,the treatment method can prolong the survival time,inhibit the serum VEGF levels. The decrease level of serum VEGF levels is positively correlated with therapeutic efficacy,suggesting that the levels have a certain assessment significance.