含多西他赛联合方案治疗晚期胃癌近远期效果及对可溶性细胞间黏附因子-1和E-钙黏蛋白的影响

Short-term and long-term effects of docetaxel on patients with advanced gastric cancer and effects on soluble intercellular adhesion factor-1 and E-cadherin

目的:探讨含多西他赛联合方案治疗晚期胃癌近远期效果及对可溶性细胞间黏附因子-1(sICAM-1)、E-钙黏蛋白(E-cadherin)的影响,为临床治疗晚期胃癌提供参考。方法:选取2015年1月至2018年1月于南通市第二人民医院就诊的78例晚期胃癌患者,按随机数字表法分为观察组和对照组,每组各39例。对照组接受卡培他滨及奥沙利铂治疗,观察组接受多西他赛联合卡培他滨、奥沙利铂治疗。比较治疗2周期(21 d为1周期)后两组的疗效及药品不良反应(ADRs)发生情况、治疗前后血sICAM-1、E-cadherin变化情况。随访至2019年10月,观察两组患者生存情况并绘制生存曲线。结果:化疗前两组患者sICAM-1及E-cadherin水平无显著差异(P>0.05),治疗2周期后观察组sICAM-1较对照组显著降低(P<0.05),E-cadherin较对照组显著升高(P<0.05),观察组总缓解率高于对照组(69.0%vs 45.0%,P<0.05)。两组患者胃肠道反应、周围神经毒性、骨髓抑制及心血管系统毒性发生率差异无统计学意义(P>0.05)。随访时间为20~56个月,平均随访时间(28.6±4.1)个月。Kaplan-Meier法联合对数秩检验显示,观察组累计总生存率高于对照组,差异有统计学意义(P<0.05)。结论:多西他赛联合卡培他滨、奥沙利铂治疗晚期胃癌近远期效果显著,安全性高,还可改善sICAM-1及E-cadherin水平。

Objective:To investigate the short-term and long-term effects of docetaxel in the treatment of patients with advanced gastric cancer and its effects on soluble intercellular adhesion factor-1(sICAM-1)and E-cadherin,so as to provide evidence for clinical treatment of advanced gastric cancer.Methods:A total of 78 patients with advanced gastric cancer who were admitted to the Second People’s Hospital of Nantong from January 2015 to January 2018 were enrolled for study and were divided into the observation group(39 cases)and the control group(39 cases)by the random number table method.The patients in the control group received capecitabine and oxaliplatin,and the patients in the observation group received docetaxel plus capecitabine and oxaliplatin.The efficacy and adverse drug reactions(ADRs)of the two groups after 2 cycles of treatment,and the changes in blood levels of sICAM-1 and E-cadherin before and after treatment were observed.Up to the follow-up time of October 2019,the survival rate of the two groups of patients and survival curve were observed.Results:The levels of sICAM-1 and E-cadherin in the two groups before chemotherapy were not significantly different(P>0.05).After 6 cycles of treatment,the levels of sICAM-1 in the observation group were lower than those in the control group(P<0.05),and the levels of E-cadherin were higher than those in the control group(P<0.05).The total remission rate of the observation group was higher than that of the control group(69.0%vs 45.0%,P<0.05).There was no significant difference in the incidence of gastrointestinal reactions,peripheral neurotoxicity,myelosuppression and cardiovascular system toxicity when comparisons were made between the two groups(P>0.05).The follow-up time was 20-56 months,with the mean follow-up time of(28.6±4.1)months.The Kaplan-Meier method combined with log-rank test showed that the cumulative total survival rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:The treatment of docetaxel combined with capecitabine and oxaliplatin has a short and long term significant effects,with good safety in the treatment of advanced gastric cancer,and could also improve the levels of sICAM-1 and E-cadherin.