白蛋白结合型紫杉醇联合替吉奥治疗晚期胃癌术后复发的临床效果研究

The clinical effect of albumin-bound paclitaxel combined with Tiggio in the treatment of postoperative recurrence of advanced gastric cancer

目的探讨白蛋白结合型紫杉醇联合替吉奥治疗晚期胃癌术后复发的效果。方法选取2016年1月至2019年1月在铜陵市人民医院肿瘤科就诊的晚期胃癌术后复发患者72例,按治疗方案的不同,将其分为单药组与联合组,单药组采用替吉奥治疗(36例),联合组为替吉奥联合白蛋白结合型紫杉醇治疗(36例)。两组均治疗3个疗程。治疗后对患者进行随访,随访截至2021年1月。比较治疗后两组的近期临床效果及相关肿瘤标志物水平,统计不良反应,采用Log-rankχ^(2)检验比较两组患者的中位总生存期(mOS)及中位无进展生存期(mPFS)。结果治疗后,有效率(69.44%vs.41.67%)比较,联合组高于单药组(P<0.05),疾病控制率(86.11%vs.63.89%)比较,联合组高于单药组(P<0.05)。治疗期间两组病死率差异无统计学意义(2.78%vs.5.56%,P>0.05)。治疗后,两组血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)]水平均降低,且联合组低于单药组(P<0.05)。两组不良反应发生率差异无统计学意义(16.67%vs.13.89%,P>0.05)。单药组的mOS为10.9(95%CI:8.2~11.7)个月,mPFS为8.2(95%CI:7.1~9.8)个月,联合组的mOS为16.1(95%CI:14.5~17.2)个月,mPFS为13.7(95%CI:11.9~14.2)个月,联合组的mOS及mPFS均高于单药组(P<0.05)。结论以白蛋白结合型紫杉醇联合替吉奥治疗晚期胃癌术后复发,可延长患者生存时间,有效提高疾病控制率,降低肿瘤标志物水平,且未增加不良反应,安全性较高,疗效显著。

Objective To explore the effect of albumin-bound paclitaxel combined with Tiggio in the therapy of postoperative recurrence of advanced gastric cancer.Methods A total of 72 patients with postoperative recurrence of advanced gastric cancer who were treated in the Oncology Department of Tongling People’s Hospital from January 2016 to January 2019,and they were divided into single-drug group(36 cases)and combination group(36 cases).The single-drug group was treated with Tiggio,and the combination group was treated with albumin-bound paclitaxel on this basis.Both groups were treated for 3 courses.The patients were followed up after treatment.The follow-up period was as of January 2021.The short-term clinical effects and related tumor marker levels of the two groups after treatment were compared,and adverse reactions were counted during treatment.The Log-rank test was used to compare the median overall survival(mOS)and median progression-free survival(mPFS)of the two groups.Results After treatment,compared with the effective rate(69.44%vs.41.67%),the combination group was higher than the single-drug group(P<0.05),and compared with the disease control rate(86.11%vs.63.89%),the combination group was higher than the single-drug group(P<0.05).There was no significant difference in mortality between the two groups during the treatment period(2.78%vs.5.56%,P>0.05).After treatment,the two groups of serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 72-4(CA72-4)]levels decreased,and the combination group was lower than single-drug group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(16.67%vs.13.89%,P>0.05).The mOS of the single-drug group was 10.9(95%CI:8.2-11.7)months,the mPFS was 8.2(95%CI:7.1-9.8)months,and the mOS of the combination group was 16.1(95%CI:14.5-17.2)months,mPFS was 13.7(95%CI:11.9-14.2)months.The mOS and PFS of the combination group were higher than those of the single-drug group(P<0.05).Conclusions The combination of albumin-bound paclitaxel and tigio for postoperative recurrence of advanced gastric cancer can prolong the survival time of patients,effectively improve the disease control rate,reduce the level of tumor markers,and does not increase adverse reactions.It has high safety and significant efficacy.