阿帕替尼联合SOX化疗方案对晚期胃癌患者近期疗效及免疫功能的影响

Effect of Apatinib Combined with SOX Chemotherapy Regimen on Short-term Efficacy and Immune Function in Patients with Advanced Gastric Cancer

目的:探讨阿帕替尼联合SOX化疗方案对晚期胃癌患者近期疗效及免疫功能的影响。方法:选取2019年1月-2022年1月苏州市第九人民医院肿瘤内科收治的132例晚期胃癌患者,按患者的治疗方式分为观察组和对照组,各66例,对照组患者采取SOX化疗方案,观察组在SOX化疗方案的基础上联合阿帕替尼进行治疗。比较两组疗效、肿瘤标记物及血管新生因子、免疫功能和不良反应发生情况。结果:观察组患者的ORR与DCR均高于对照组(P<0.05)。治疗前,两组癌胚抗原、糖类抗原19-9、糖类抗原125及血管内皮生长因子和胰岛素样生长因子比较,差异均无统计学意义(P>0.05);治疗后,两组上述五项指标均明显下降,且观察组均低于对照组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较,差异均无统计学意义(P>0.05);治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均升高,且观察组均高于对照组,CD8^(+)均下降,且观察组低于对照组(P<0.05)。治疗过程中,观察组贫血、恶心呕吐、便秘腹泻、食欲减退、血小板减少、周围神经毒性、肝肾功能不全、白细胞和中性粒细胞减少发生率均明显低于对照组,高血压、手足综合征发生率均高于对照组(P<0.05),两组蛋白尿、全身乏力、口腔黏膜炎发生率比较,差异均无统计学意义(P>0.05)。结论:阿帕替尼联合SOX化疗方案治疗晚期胃癌患者具有明显的效果,改善免疫功能,减少患者化疗不良反应的发生,但也需要提防联合用药后出现血压升高、手足综合征。

Objective:To investigate the effect of Apatinib combined with SOX chemotherapy regimen on the short-term efficacy and immune function of patients with advanced gastric cancer.Method:A total of 132patients with advanced gastric cancer admitted to the Department of Oncology of Suzhou Ninth People’s Hospital from January 2019 to January 2022 were selected,they were divided into observation group and control group according to treatment methods,with 66 cases in each group.The control group was treated with SOX chemotherapy regimen,and the observation group was treated with Apatinib on the basis of SOX chemotherapy regimen in the control group.The efficacy,tumor markers and angiogenesis factors,immune function and the occurrence of adverse reactions were compared between the two groups.Result:The ORR and DCR in the observation group were higher than those in the control group(P<0.05).Before treatment,there were no significant differences in carcinoembryonic antigen,carbohydrate antigen 19-9,carbohydrate antigen 125,vascular endothelial growth factor and insulin-like growth factor between the two groups(P>0.05),after treatment,the above five indexes in the two groups decreased significantly,and those in the observation group were lower than those in the control group(P<0.05).Before treatment,there were no significant differences in CD3^(+),CD4^(+),CD8^(+) and CD4^(+)/CD8^(+) between the two groups(P>0.05),after treatment,the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the observation group were higher than those in the control group,and the CD8^(+) in the observation group was lower than that in the control group(P<0.05).During the treatment,the incidences of anemia,nausea and vomiting,constipation and diarrhea,loss of appetite,thrombocytopenia,peripheral neurotoxicity,hepatorenal insufficiency,leukocyte and neutropenia in the observation group were significantly lower than those in the control group,and the incidences of hypertension and hand-foot syndrome were higher than those in the control group(P<0.05),there were no significant differences in the incidences of proteinuria,systemic fatigue and oral mucositis between the two groups(P>0.05).Conclusion:Apatinib combined with SOX chemotherapy has a significant effect in the treatment of patients with advanced gastric cancer,improving immune function and reducing the occurrence of adverse reactions to chemotherapy,however,it is also necessary to guard against the occurrence of elevated blood pressure and hand and foot syndrome after combined administration.