多西他赛联合FOLFOX方案治疗进展期胃癌术后患者的临床疗效

Clinical efficacy of docetaxel combined with FOLFOX regimen in the treatment of postoperative patients with advanced gastric cancer

目的探讨多西他赛联合奥沙利铂+亚叶酸钙+5-氟尿嘧啶(FOLFOX)方案治疗进展期胃癌术后患者的临床疗效。方法根据术后化疗方案的不同将97例进展期胃癌患者分为研究组(n=50)和对照组(n=47),对照组患者采用多西他赛联合顺铂治疗,研究组患者采用多西他赛联合FOLFOX方案治疗。比较两组患者的近期疗效、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+))、不良反应发生情况、1年生存及复发情况。结果研究组患者的疾病控制率为94.00%(47/50),高于对照组患者78.72%(37/47),差异有统计学意义(P﹤0.05)。治疗后,两组患者的CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于本组治疗前,CD8^(+)水平均低于本组治疗前,研究组患者的CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。两组患者白细胞减少、神经毒性反应、恶心呕吐、肝损伤、肾损伤发生率比较,差异均无统计学意义(P﹥0.05)。研究组患者的1年复发率为12.00%(6/50),低于对照组患者的29.79%(14/47),差异有统计学意义(P﹤0.05);研究组患者的1年生存率为92.00%(46/50),与对照组患者的78.72%(37/47)比较,差异无统计学意义(P﹥0.05)。结论多西他赛联合FOLFOX方案治疗进展期胃癌术后患者的疗效确切,能够改善患者的免疫功能,且具有一定的安全性。

Objective To investigate the clinical efficacy of docetaxel combined with oxaliplatin+leucovorin+5-fluorouracil(FOLFOX)regimen in the treatment of postoperative patients with advanced gastric cancer.Method A total of 97 patients with advanced gastric cancer were divided into study group(n=50)and control group(n=47)according to different postoperative chemotherapy regimens.Patients in the control group were treated with docetaxel combined with cisplatin,and patients in the study group were treated with docetaxel combined with the FOLFOX regimen.The short-term curative effect,T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)),adverse events,one-year survival,and oneyear recurrence were compared between the two groups.Result The disease control rate of the study group was 94.00%(47/50),which was higher than 78.72%(37/47)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups were higher than before the treatment,and the levels of CD8^(+)were lower than those before the treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the study group were higher than those in the control group,and the level of CD8^(+)was lower than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of leukopenia,neurotoxicity,nausea and vomiting,liver injury,and kidney injury between the two groups(P>0.05).The one-year recurrence rate in the study group was 12.00%(6/50),which was lower than 29.79%(14/47)in the control group,and the difference was statistically significant(P<0.05).The one-year survival rate of patients in the study group was 92.00%(46/50),compared with 78.72%(37/47)in the control group,the difference was not statistically significant(P>0.05).Conclusion Docetaxel combined with the FOLFOX regimen has a definite curative effect in the treatment of postoperative patients with advanced gastric cancer,and the regimen could improve patients’immune function with acceptable safety.