醋酸奥曲肽微球治疗胃肠胰腺神经内分泌肿瘤的疗效观察

The curative effect of octreotide acetate microsphere in the treatment of gastroenteropancreatic neuroendocrine neoplasms

目的探讨醋酸奥曲肽微球治疗胃肠胰腺神经内分泌肿瘤(GEP-NENs)的疗效。方法选择2017年11月至2019年3月我科收治GEP-NENs患者70例,随机数字表法分为GEM组及OA+GEM组各35例。GEM组采用吉西他滨(GEM)治疗,OA+GEM组采用GEM联合醋酸奥曲肽(OA)微球治疗。比较两组近期、短期远期疗效、治疗前后肿瘤标志物水平、血清激素水平、治疗后KPS评分与QOL-BREF评分及安全性。结果治疗后,OA+GEM组近期、短期远期疗效均优于GEM组,治疗有效率、疾病控制率与复发率比较,差异有统计学意义(P<0.05);治疗后,两组神经元特异性烯醇化酶(NSE)、嗜铬粒蛋白A(CgA)及癌胚抗原(CEA)水平低于治疗前,且OA+GEM组低于GEM组;两组胰岛素水平与治疗前比较显著上升,胃泌素以及胰高血糖素较治疗前显著降低,且治疗后OA+GEM组胰岛素水平高于GEM组,胃泌素与胰高血糖素水平低于GEM组,差异有统计学意义(P<0.05);OA+GEM组治疗后KPS评分与QOL-BREF评分明显优于GEM组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论OA微球治疗GEP-NENs可以明显改善患者肿瘤标志物水平,纠正患者体内紊乱胰岛素、胃泌素与胰高血糖素水平,治疗有效率高,安全性高。

Objective To explore the curative effect of octreotide acetate(OA)microsphere in the treatment of gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs).Methods Seventy patients with GEP-NENs who were treated in our department from November 2017 to March 2019 were selected as the subjects.They were divided into gemcitabine(GEM)group and OA+GEM group by the random number table method,35 in each group.The GEM group was treated with GEM while the OA+GEM group was treated with GEM+OA microsphere.The short-term and long-term curative effect,levels of tumor markers and serum hormones before and after treatment,KPS scores and QOL-BREF scores after treatment and safety were compared between the two groups.Results After treatment,the short-term and long-term curative effect in the OA+GEM group were better than those in the GEM group.Besides,the differences in treatment response rate,disease control rate and recurrence rate were statistically significant(P<0.05).After treatment,NSE,CEA and CgA levels in both groups were significantly decreased(P<0.05),and levels of above indexes in the OA+GEM group were lower than those in the GEM group(P<0.05).After treatment,insulin levels in both groups were significantly increased,while gastrin and glucagon levels were significantly decreased.After treatment,insulin level in the OA+GEM group was higher than that in the GEM group,while gastrin and glucagon levels were lower than those in the GEM group(P<0.05).After treatment,scores of KPS and QOL-BREF in the OA+GEM group were significantly better than those in the GEM group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of OA microsphere in the treatment of GEP-NENs can significantly improve the levels of tumor markers and correct the disordered levels of insulin,gastrin and glucagon in the patients.The response rate and safety are high,and recurrence is little.