TS方案与单药S-1方案治疗进展期胃癌的疗效对比研究

Comparative Study on the Efficiency of TS Regimen and Monotherapy S-1 Regimen for Advanced Gastric Cancer

目的探讨紫杉醇脂质体联合替吉奥(TS方案)与单用替吉奥(S-1)治疗胃癌根治术后患者的临床效果、对患者血管内皮生长因子C(VEGF-C)、VEGF-D及预后的影响。方法选取我院和哈尔滨市胸科医院诊治的80例胃癌根治术后患者,根据治疗方法分为联合组40例(TS方案)、对照组40例(S-1),所有患者至少完成3个周期的治疗,对比化疗前、化疗结束后2周两组患者的血清VEGF-C、VEGF-D水平、1年、3年无无疾病进展生存期(Progression Free Survival,PFS)、总生存期(Overan Survival,OS)及生存率。结果治疗前,两组患者血清VEGF-C、VEGF-D水平差异无统计学意义(P>0.05);化疗后,两组患者的血清VEGF-C、VEGF-D水平较治疗前均显著降低(P<0.05),联合组显著低于对照组(P<0.05);联合组的骨髓抑制严重程度显著高于对照组(P<0.05),两组患者的恶心呕吐、腹泻、肝功能损害、肾功能损害、周围神经炎、心脏毒性发生率比较,差异无统计学意义(P>0.05);联合组和对照组的1年PFS生存率、3年PFS生存率、1年OS生存率、3年OS生存率比较,差异均无统计学意义(P>0.05);联合组的3年PFS生存期28.0个月长于对照组的19.0个月(P<0.05);联合组的3年OS生存期33.0个月长于对照组的26.0个月(P<0.05)。结论紫杉醇脂质体联合S-1有利于延长胃癌根治术后患者的远期生存时间,进一步降低血清VEGF-C、VEGF-D水平。

Objective To investigate the clinical effect of paclitaxel liposomes combined with S-1(TS regimen)and S-1 alone in the treatment of patients with gastric cancer after radical resection.The serum levels of vascular endothelial growth factor C(VEGF-C),vascular endothelium growth factor D(VEGF-D)and prognosis.Methods 80 patients with gastric cancer who underwent radical operation were divided into joint group(TS regimen,40 cases)and control group(S-1 alone,40 cases)according to the treatment method.All patients completed at least 3 cycles of treatment.The levels of serum VEGF-C and VEGF-D,1-year and 3-year PFS,overall survival(OS),and survival rates were compared between the two groups before and two weeks after chemotherapy.Results Before chemotherapy,there was no significant difference in serum VEGF-C and VEGF-D between the joint group and the control group(P>0.05).After chemotherapy,the levels of serum VEGF-C and VEGF-D in the two groups were significantly lower than those before treatment(P<0.05).The levels of serum VEGF-C and VEGF-D in the joint group were significantly lower than those in the control group(P<0.05).The severity of myelosuppression in the joint group was significantly greater than that in the control group(P<0.05).There was no significant difference between the two groups in the incidence of nausea and vomiting,diarrhea,liver function damage,renal dysfunction,peripheral neuritis and cardiotoxicity(P>0.05).No significant differences were observed in the 1-year and 3-year PFS rates and 1-year and 3-year OS rates between the joint group and the control group(P>0.05).The 3-year PFS of the joint group was 28.0 months,longer than that of the control group(19.0 months)(P<0.05).The 3-year overall survival period of the joint group(33 months)was longer than that of the control group(26months)(P<0.05).Conclusion Paclitaxel liposomes combined with S-1 is beneficial to prolong the long-term survival time of patients after radical gastrectomy and further decrease serum VEGF-C and VEGF-D levels.