顺铂腹腔热灌注联合静脉化疗治疗胃癌疗效及对血清IGF-1 VEGF EGFR水平的影响

Curative Effect of Cisplatin Hyperthermic Intraperitoneal Chemotherapy Combined with Intravenous Chemotherapy in the Treatment of Gastric Cancer and Its Influence on Serum IGF-1 VEGF and EGFR Levels

目的:探讨顺铂腹腔热灌注(HIPEC)联合静脉化疗治疗胃癌的疗效以及对血清胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、表皮生长因子受体(epidermal growth factor receptor,EGFR)水平的影响。方法:112例胃癌患者依据患者自愿原则分为观察组(n=60)和对照组(n=52),分别给予顺铂HIPEC+静脉化疗和单一静脉化疗,比较两组近期疗效及不良反应情况,并测定治疗前后血清IGF-1、VEGF、EGFR水平。结果:观察组近期总有效率为61.67%,显著高于对照组的36.54%(P<0.05);观察组恶心呕吐、骨髓抑制的发生率较对照组略高,有统计学差异(P<0.05);与治疗前比较,两组治疗后血清IGF-1、VEGF、EGFR水平均降低,且观察组各指标治疗前后差值大于对照组,有统计学差异(P<0.05)。结论:顺铂HIPEC联合静脉化疗治疗胃癌的近期疗效优于单纯静脉化疗,能在不增加毒副作用的基础上改善血清IGF-1、VEGF、EGFR水平。

Objective:To investigate the curative effect of cisplatin hyperthermic intraperitoneal chemotherapy(HIPEC)combined with intravenous chemotherapy in the treatment of gastric cancer,and its influence on serum insulin-like growth factor-1(IGF-1),vascular endothelial growth factor(VEGF)and epidermal growth factor receptor(EGFR)levels.Methods:Totally 112 patients with gastric cancer were divided into observation group(n=60)and control group(n=52)according to the principle of voluntariness.The observation group was given cisplatin HIPEC combined with intravenous chemotherapy,while the control group was given intravenous chemotherapy alone.The short-term curative effect,quality of life and adverse reactions were compared between the two groups.The levels of serum IGF-1,VEGF and EGFR were determined before and after treatment.Results:The short-term total response rate in the observation group was 61.67%,which was significantly higher than the control group at 36.54%(P<0.05).The incidence of nausea,vomiting and bone marrow suppression in the observation group was slightly higher than that in the control group,with statistical differences(P<0.05).After treatment,serum IGF-1,VEGF and EGFR levels were significantly reduced in the two groups,and the difference of each index in the observation group was greater than that in the control group.(P<0.05).Conclusion:Cisplatin HIPEC in combination with intravenous chemotherapy can achieve better short-term curative effect than intravenous chemotherapy alone in the treatment of gastric cancer.The former can significantly improve serum IGF-1,VEGF and EGFR levels of patients without increasing side effects.