体质量变化对老年晚期胃癌患者化疗效果的影响

Effect of body mass change on chemotherapy in elderly patients with advanced gastric cancer

目的探讨体质量变化对老年晚期胃癌患者化疗效果的影响。方法选取2012年1月至2017年6月河南省人民医院收治的老年晚期胃癌患者100例,根据患者个体情况给予奥沙利铂联合替吉奥方案(SOX方案)与奥沙利铂联合氟尿嘧啶、亚叶酸钙方案(mFOLFOX4方案)进行化疗。根据化疗过程中患者体质量的增减进行分组,其中体质量增加的48例患者作为观察组,体质量减轻的52例患者作为对照组。化疗后2个周期,比较两组患者的化疗效果及不良反应。结果化疗后,两组客观缓解率比较差异未见统计学意义(P<0.05)。化疗后,观察组白细胞介素-2、γ-干扰素水平高于对照组,差异有统计学意义(P<0.05)。观察组、对照组无进展生存期分别为5.7、4.7个月,差异有统计学意义(P<0.05);观察组、对照组总生存期分别为11.9、10.5个月,差异未见统计学意义(P>0.05)。两组不良反应主要以骨髓抑制、胃肠道反应和神经毒性等为主,对照组贫血发生率高于观察组(P<0.05),两组其余不良反应发生率比较差异未见统计学意义(P>0.05)。结论化疗过程中,患者体质量增加时,贫血发生率下降,可增强患者免疫力,延长无进展生存期。

Objective To discuss the influence of body mass change on curative effects of chemotherapy on elderly patients with advanced gastric cancer. Methods A total of 100 elderly patients with advanced gastric cancer treated from January 2012 to June 2017 in Henan Provincial People’s Hospital were selected. Oxaliplatin combined with tegio regimen (SOX regimen) and oxaliplatin combined with fluorouracil and calcium folinate regimen (mFOLFOX4 regimen) were given to patients for chemotherapy according to individual conditions. All the patients were grouped according to the increase or decrease of body weight during chemotherapy. Forty-eight patients with increased body weight were selected as observation group, and 52 patients with decreased body weight were selected as control group. After 2 cycles of chemotherapy, the chemotherapy effect and adverse reactions of the two groups were compared. Results After chemotherapy, there was no significant difference in objective remission rate between the two groups (P<0.05). The levels of interleukin-2 and interferon-γ after chemotherapy in observation group were higher than those in control group (P<0.05). Progression-free survival was 5.7 and 4.7 months in observation group and control group, respectively, and the difference was statistically significant between the two groups (P<0.05). The overall survival of observation group and control group were 11.9 and 10.5 months, respectively, and difference was not significant between the two groups (P>0.05). The main adverse reactions of the two groups were myelosuppression, gastrointestinal reactions and neurotoxicity. The incidence of anemia in control group was higher than that in observation group (P<0.05), and there was no significant difference in the incidence of other adverse reactions between the two groups (P>0.05). Conclusions During the course of chemotherapy, increase in body mass will result in decrease in the incidence of anemia, improvement in immunity and progression-free survival.