多西他赛、雷替曲塞治疗无法手术胃癌患者的疗效及作用机制

Efficacy and mechanism of docetaxel combined raltitrexed in patients with inoperable gastric cancer

目的探讨多西他赛联合雷替曲塞治疗无法手术的晚期胃癌患者的疗效及对血清dickkopf WNT信号通路抑制剂1(DKK1)、三叶因子3(TFF3)和内皮抑制蛋白(endostatin)水平的影响。方法采用随机数字表法将92例晚期无法接受手术治疗的胃癌患者分为研究组和对照组,每组46例。研究组采用多西他赛联合雷替曲塞治疗,对照组采用多西他赛联合5-氟尿嘧啶治疗。比较两组患者的疗效,化疗前后血清endostatin、DKK1、TFF3水平,不良反应发生情况及生存情况。结果化疗后,研究组患者总有效率为75.56%,高于对照组的52.27%,差异有统计学意义(P﹤0.05)。化疗前,两组患者血清endostatin、DKK1、TFF3水平比较,差异均无统计学意义(P﹥0.05);化疗后,研究组患者血清DKK1、TFF3水平均低于对照组,endostatin水平高于对照组,差异均有统计学意义(P﹤0.05)。研究组患者恶心呕吐、骨髓抑制发生率均低于对照组,差异均有统计学意义(P﹤0.05)。研究组患者中位生存时间为22.0个月,长于对照组的17.0个月,差异有统计学意义(P﹤0.05)。结论多西他赛联合雷替曲塞治疗无法手术的晚期胃癌患者较多西他赛联合5-氟尿嘧啶更具有优势。

Objective To explore the efficacy of docetaxel combined raltitrexed in the treatment of inoperable patients with advanced gastric cancer and effect on the levels of serum dickkopf WNT signaling pathway inhibitor 1(DKK1),trefoil factor 3(TFF3),and endostatin.Method The 92 patients with inoperable advanced gastric cancer were randomly divided into the study group(n=46,treated with docetaxel+raltitrexed)and control group(n=46,treated with docetaxel+5-fluorouracil)by random number table.The efficacy,levels of serum endostatin,DKK1,and TFF3 before and after chemotherapy,adverse reactions and survival were compared between the two groups.Result After chemotherapy,the total effective rate of the study group was 75.56%,higher than that of the control group 52.27%(P<0.05).There were no significant differences for the levels of serum endostatin,DKK1,TFF3 between the two groups before chemotherapy(P>0.05)versus lower levels of serum DKK1 and TFF3,and higher endostatin in the study group than those in the control group after chemotherapy(P<0.05).Incidence of nausea,vomiting and bone marrow suppression in the study group were lower than those in the control group(P<0.05).The median survival of the study group was longer than that of the control group(22.0 months vs 17.0 months,P<0.05).Conclusion Docetaxel+raltitrexone is more effective in the treatment of inoperable patients with advanced gastric cancer than that of docetaxel+5-fluorouracil.