卡培他滨与奥沙利铂联用方案对中晚期胃癌患者的疗效及其对血清癌胚抗原及T细胞水平影响

Clinical Efficacy of Xeloda Combined with Oxaliplatin in Patients with Advanced Gastric Cancer and Its Influence on CEA and T Cell Levels

目的:探究卡培他滨(xeloda)与奥沙利铂(oxaliplatin)(以下简称XELOX)方案干预中晚期胃癌患者的临床疗效及其对CA19-9等癌胚抗原标志物及T细胞水平改善的影响。方法:选取2014年1月—2015年12月间收治的中晚期胃癌患者132例资料,按治疗方法的不同将其分为观察组和对照组,每组66例;观察组患者接受XELOX方案治疗,对照组患者(66例)接受FOLOFX方案治疗,比较两组患者治疗后的总有效率和不良反应的发生率差异,以及治疗前后肿瘤相关抗原指标(CEA、CA125、CA19-9、TPS)及血清T细胞亚群(CD3、CD4、CD8)水平测得值的变化情况。结果:两组患者治疗后的总有效率及疾病控制率经组间比较其差异均无统计学意义(P>0.05);观察组患者治疗后3年复发率(57.58%)稍低于对照组(63.64%),但经组间比较其差异也无统计学意义(χ2=0.608,P0.433>0.05);治疗后1年和3年的生存率(93.94%、75.76%)略高于对照组(90.91%、66.67%),但经组间比较其差异也无统计学意义(P>0.05);观察组患者治疗后手足综合征的发生率显著高于对照组(P<0.05),而胃肠道反应、口腔黏膜炎症及白细胞抑制发生率低于对照组(P>0.05);两组患者治疗后肝功能异常发生率经组间比较其差异无统计学意义(P>0.05);治疗6周后观察组患者肿瘤相关抗原指标水平值均低于对照组(P<0.05),而血清T细胞亚群(CD3、CD4、CD8)均显著高于(P<0.05)。结论:采用XELOX方案干预中晚期胃癌患者的疗效优于FOLOFX方案,且不良反应发生率低,有效提高了生存率,改善了生活质量。

Objective:To explore the clinical efficacy of xeloda combined with oxaliplatin (XELOX) in the intervention of patients with advanced gastric cancer and their influence on CA19-9 and other cancer-embryo antigen (CEA) markers and T cell level improvement.Methods:The data of 132 patients with advanced gastric cancer admitted from January 2014 to December 2015 were selected.They were divided into observation group and control group according to different treatment methods,with 66 cases in each group.Patients in the observation group received XELOX regimen, while patients in the control group (66 cases) received FOLOFX regimen.The differences in total response rate and incidence of adverse reactions after treatment between the two groups as well as the changes in tumor related antigen indicators (CEA,CA125,CA19-9 and TPS) and serum T-cell subsets (CD3,CD4 and CD8) measured before and after treatment were compared.Results:There was no statistically significant difference between the two groups in the total effective rate and disease control rate after treatment (P>0.05).Three years after treatment,the recurrence rate of the observation group (57.58%) was slightly lower than that of the control group (63.64%),but there was no statistically significant difference between the two groups (χ2=0.608,P0.433>0.05).The 1- year and 3- years survival rates (93.94%, 75.76%) were slightly higher than those of the control group (90.91%,66.67%),but there was no statistically significant difference between the two groups (P>0.05).The incidence of hand-foot syndrome in the observation group was significantly higher than that in the control group (P<0.05),while the incidence of gastrointestinal reactions,oral mucosal inflammation and leukocyte inhibition was lower than that in the control group (P>0.05).There was no statistically significant difference between the two groups in the incidence of abnormal liver function after treatment (P>0.05).After 6 weeks of treatment,the level of tumor-related antigen indicators in the observation group was lower than that in the control group (P<0.05),while the serum T-cell subsets (CD3,CD4 and CD8) were significantly higher than those in the control group (P<0.05).Conclusion:The efficacy of XELOX regimen for intervention of patients with advanced gastric cancer was better than that of FOLOFX regimen,and the incidence of adverse reactions was low,which effectively improved the survival rate and the quality of life.