西妥昔单抗联合铂类药物灌注治疗胃癌所致恶性腹水患者的疾病控制效果

Effect of cetuximab combined with platinum perfusion on disease control in patients with malignant ascites caused by gastric cancer

目的观察西妥昔单抗联合铂类药物灌注治疗胃癌所致恶性腹水对患者疾病控制的效果。方法选取2015年7月-2018年6月海南省第三人民医院普通外科诊治胃癌恶性腹水患者100例,采用随机数字表法分为2组,观察组(n=50)和对照组(n=50)。对照组给予铂类药物灌注治疗,观察组在此基础上联合西妥昔单抗治疗。治疗2周后比较2组疾病控制率、腹水控制效果,记录治疗前后血管内皮生长因子(VEGF)、癌胚抗原(CEA)、腹水糖链抗原(CA199)、CA125、生活质量评分变化,记录治疗期间不良反应。结果治疗后,观察组疾病控制率82.00%明显高于对照组64.00%(χ^2=4.109,P=0.042);腹水控制效果88.00%高于对照组72.00%(χ^2=4.000,P=0.045);2组患者血清VEGF、CEA、CA199、CA125等指标表达水平均降低,且观察组均低于对照组(t=6.650、5.099、5.860、6.222,P均=0.000);2组患者躯体功能、物质生活、认知功能、心理功能等生活质量指标评分均有升高,且观察组明显高于对照组(t=5.015、4.990、7.940、3.354,P均=0.000);2组患者均出现乏力、发热、胃肠道反应、白细胞降低等不良反应,但观察组发生率明显低于对照组(12.00%vs.30.00%,χ^2=4.882,P=0.027)。结论西妥昔单抗联合铂类药物灌注治疗胃癌所导致的恶性腹水效果显著,可降低肿瘤标志物表达,提高患者生活质量,且安全性高。

Objective To observe the effect of cetuximab combined with platinum perfusion in the treatment of malignant ascites caused by gastric cancer.Methods One hundred patients with malignant ascites of gastric cancer treated by Departement of General Surgery in Hainan Third People’s Hospital from July 2015 to June 2018 were selected.They were divided into two groups by random number table method.The observation group(n=50)and the control group(n=50). The control group was given platinum perfusion therapy,while the observation group was treated with cetuximab on this basis.Two weeks after treatment,the disease control rate and ascites control effect were compared between the two groups.The changes of VEGF,CEA,CA199,CA125 and quality of life score were recorded before and after treatment,and the adverse reactions during treatment were recorded.Results After treatment,the disease control rate of the observation group was 82.00% higher than that of the control group(64.00%)(χ~2 =4.109,P=0.042);the ascites control effect was 88.00% higher than the control group 72.00%(χ~2 =4.000,P =0.045);The serum levels of VEGF,CEA,CA199,CA125 and other indicators decreased,and the observation group was lower than the control group(P<0.01);the body function,material life,The scores of cognitive function,psychological function and other quality of life indicators were increased,and the observation group was significantly higher than the control group(P<0.01);both groups of patients showed fatigue,fever,Adverse reactions such as gastrointestinal reactions and leukopenia were observed,but the incidence of the observation group was significantly lower than that of the control group(12.00% vs.30.00%,χ~2=4.882,P=0.027).Conclusion Cetuximab combined with platinum perfusion has a significant effect on malignant ascites caused by gastric cancer.It can reduce the expression of tumor markers and improve the quality of life of patients.It is safe and worthy of clinical application.