曲妥珠单抗联合卡培他滨+顺铂化疗方案治疗HER2阳性晚期胃癌的疗效研究

Effect of trastuzumab combined with XP chemotherapy on advanced HER2 positive gastric cancer

目的探究曲妥珠单抗联合卡培他滨+顺铂化疗方案治疗人类表皮生长因子受体2(HER2)阳性晚期胃癌的临床效果与安全性。方法选择126例HER2阳性晚期胃癌患者进行前瞻性研究,随机分为研究组和对照组,各63例。对照组采用卡培他滨+顺铂化疗方案,研究组在对照组治疗方案基础上加用曲妥珠单抗治疗,观察比较两组患者临床治疗效果、肿瘤标记物水平、毒副反应发生情况及严重程度。结果两组患者随访时间3~18个月,中位随访时间9.40个月。研究组治疗总有效率与控制率均明显高于对照组(χ^2分别=5.43、5.42,P均<0.05);研究组无进展生存期(PFS)与总生存期(OS)均长于对照组,差异均有统计学意义(t分别=12.80、13.27,P均<0.05)。研究组治疗后的癌胚抗原(CEA)、人单核细胞趋化蛋白-1(MCP-1)、白细胞介素1β(IL-1β)与血管内皮生长因子(VEGF)水平均明显低于对照组治疗后,差异均有统计学意义(t分别=38.43、9.30、14.38、7.94,P均<0.05),两组患者恶心呕吐、肝功能损害、骨髓抑制、手足综合征等严重程度比较,差异均无统计学意义(Z分别=0.10、0.39、1.15、1.28,P均>0.05)。结论曲妥珠单抗联合卡培他滨+顺铂化疗方案治疗HER2阳性晚期胃癌效果肯定,能有效提升患者近期疗效与远期疗效,毒副作用小,安全性高。

Objective To explore the clinical efficacy and safety of trastuzumab combined with XP chemotherapy regimen(capecitabine+cisplatin)in the treatment of advanced human epidermal growth factor receptor-2(HER2)positive gastric cancer.Methods Totally 126 patients with advanced HER2 positive gastric cancer were selected and randomly divided into study group and control group with 63 patients in each.The control group was treated with XP chemotherapy regimen,while the study group was treated with trastuzumab on the basis of the treatment of the control group.The clinical treatment effect,tumor marker level,adverse reactions between two groups were observed and compared.Results Patients in both groups were followed up for 3 to 18 months,and the median follow-up time was 9.40 months.The total effective rate and control rate of the study group were significantly higher than those of the control group(χ^2=5.43,5.42,P<0.05).The PFS and OS of the study group were longer than those of the control group(t=12.80,13.27,P<0.05).After treatment,the carcinoembryonic antigen(CEA),monocyte chemotactic protein 1(MCP-1),interleukins 1β(IL-1β)and vascular endothelial growth factor(VEGF)levels in study group were significantly lower than those in the control group(t=38.43,9.30,14.38,7.94,P<0.05).The differences in nausea and vomiting,liver function damage,bone marrow inhibition,and hands and feet syndrome were not statistically significant(Z=0.10,0.39,1.15,1.28,P>0.05).Conclusion Trastuzumab combined with XP chemotherapy in the treatment of advanced HER2-positive gastric cancer can effectively improving the short-term and long-term efficacy with small side effects and high safety.