阿帕替尼联合替吉奥治疗老年晚期胃癌的近期疗效及对血清肿瘤标志物水平的影响

Short-term efficacy of apatinib combined with S-1 in the treatment of elderly patients with advanced gastric cancer and its influence on serum tumor markers

目的探讨阿帕替尼联合替吉奥治疗老年晚期胃癌的近期疗效及对血清肿瘤标志物水平的影响。方法选取河南省荣军医院2017年1月至2018年10月收治的92例老年晚期胃癌患者,按照随机抽样的方式分为观察组和对照组,每组46例,对照组口服单药替吉奥治疗,观察组在对照组治疗的基础上加用阿帕替尼治疗,比较2组近期疗效、血清肿瘤标志物水平变化及不良反应发生情况。结果观察组患者的治疗有效率为60.87%(28/46),显著高于对照组的36.96%(17/46),差异有统计学意义(χ^(2)=4.356,P=0.022)。治疗后,观察组血清糖类抗原199(CA199)、CA125、癌胚抗原水平均低于对照组,差异均有统计学意义(t=4.125,P=0.039;t=5.028,P=0.036;t=4.324,P=0.038)。观察组患者的高血压、蛋白尿、口腔黏膜炎和手足综合征发生率均高于对照组,差异均有统计学意义(χ^(2)=6.615,P=0.019;χ^(2)=5.493,P=0.034;χ^(2)=6.825,P=0.009;χ^(2)=5.494,P=0.033)。结论阿帕替尼联合替吉奥治疗老年晚期胃癌是安全有效的,有利于降低血清肿瘤标志物水平,有效提升了患者的近期疗效,且耐受性强。

Objective To investigate the short-term efficacy of apatinib combined with S-1 in the treatment of elderly patients with advanced gastric cancer and its influence on serum tumor markers.Methods Ninty-two elderly patients with advanced gastric cancer in the Henan Rongjun Hospital from January 2017 to October 2018 were selected,and they were divided into two groups according to random number table,with 46 patients in each group.The patients in the control group were given with S-1,while the patients in the observation group were treated with apatinib combined with S-1.The short-term efficacy,serum tumor markers and adverse reactions were compared between the two groups.Results The total response rate in observation group were higher than that in the control group[60.87%(28/46)and 36.96%(17/46);χ^(2)=4.356,P=0.022].After treatment,the serum carbohydrate antigen 199(CA199),CA125 and carcinoembryonic antigen levels in the observation group were lower than those in the control group(t=4.125,P=0.039;t=5.028,P=0.036;t=4.324,P=0.038).The incidence of hypertension,proteinuria,oral mucositis and hand foot syndrome in the observation group were higher than those in the control group(χ^(2)=6.615,P=0.019;χ^(2)=5.493,P=0.034;χ^(2)=6.825,P=0.009;χ^(2)=5.494,P=0.038).Conclusion Apatinib combined with S-1 is safe and effective on elderly patients with advanced gastric cancer,which can decrease the levels of tumor markers,effectively improve the short-term efficacy of patients,and the adverse reactions can be tolerated.