吉西他滨和奥沙利铂联合阿帕替尼治疗胆囊癌效果观察

Efficacy observation of gemcitabine and oxaliplatin combined with apatinib in treatment of patients with gallbladder cancer

目的观察吉西他滨和奥沙利铂联合靶向药物阿帕替尼治疗胆囊癌的效果。方法对2017年5月至2018年12月山东省海阳市人民医院、烟台市烟台山医院和烟台市海阳荣军医院收治的82例胆囊癌患者病例资料进行回顾性分析,依据用药情况分为对照组与观察组,各41例。对照组患者采用吉西他滨联合奥沙利铂方案治疗(吉西他滨1000 mg/m^2,30 min静脉滴注,第1、8天;奥沙利铂100 mg/m^2,3 h静脉滴注,第1天),观察组在对照组的治疗方法基础上,联合甲磺酸阿帕替尼500 mg/d。比较两组患者治疗效果、血清肿瘤标志物水平、不良反应及生存情况。结果对照组患者的疾病控制率为70.73%(29/41),低于观察组的92.68%(38/41)(χ^2=6.609,P<0.05)。治疗后观察组血管内皮生长因子(VEGF)、癌胚抗原(CEA)、可溶性白细胞介素2受体(sIL-2R)及Dickkopf-1水平均低于观察组,差异均有统计学意义(t值分别为6.011、3.048、4.444、4.514,均P<0.05)。观察组患者蛋白尿、手足综合征发生率均低于对照组,差异均有统计学意义(χ^2值分别为6.116、4.986,均P<0.05)。随访1年,观察组2例死亡,生存率为95.13%(39/41),对照组8例死亡,生存率为80.49%(33/41),两组患者随访后生存率差异有统计学意义(χ^2=4.100,P<0.05)。结论吉西他滨和奥沙利铂联合阿帕替尼治疗胆囊癌效果较好,可有效降低患者血清肿瘤标志物水平,改善患者的预后。

Objective To observe the efficacy of gemcitabine and oxaliplatin combined with targeted drug apatinib in the treatment of gallbladder cancer.Methods The data of 82 patients with gallbladder cancer who were admitted to Haiyang People's Hospital,Yantaishan Hospital and Rongjun Hospital of Yantai City in Shandong Province from May 2017 to December 2018 were retrospectively analyzed.The patients were divided into control group and observation group according to the medication,with 41 cases in each group.Patients in the control group were treated with gemcitabine combined with oxaliplatin regimen(gemcitabine 1000 mg/m^2 was injected intravenously for 30 minutes on the 1st and 8th day,and oxaliplatin 100 mg/m^2 was injected intravenously for 3 hours on the 1st day),the observation group was combined with apatinib mesylate 500 mg/d based on the treatment method of the control group.The treatment effect,serum tumor marker levels,adverse reactions and survival were compared between the two groups.Results The disease control rate of the control group was 70.73%(29/41),which was significantly lower than that of the observation group[92.68%(38/41)](χ^2=6.609,P<0.05).After treatment,the levels of vascular endothelial growth factor(VEGF),carcinoembryonic antigen(CEA),soluble interleukin-2 receptor(sIL-2R)and Dickkopf-1 in the observation group were significantly lower than those in the observation group,and the differences were statistically significant(t values were 6.011,3.048,4.444,and 4.514,all P<0.05).The incidence of proteinuria and hand-foot syndrome in the observation group were significantly lower than those in the control group,and the differences were statistically significant(χ^2 values were 6.116 and 4.986,both P<0.05).During the 1-year follow-up,2 patients in the observation group died,and the survival rate was 95.13%(39/41);8 patients in the control group died,and the survival rate was 80.49%(33/41).There was a statistical difference in the survival rate between the two groups(χ^2=4.100,P<0.05).Conclusion Gemcitabine and oxaliplatin combined with apatinib mesylate are effective in treating gallbladder cancer,which can effectively reduce serum tumor marker levels and improve the prognosis of gallbladder cancer patients.