卡培他滨不同给药方案治疗晚期消化道肿瘤的临床效果比较

Comparison of clinical effects of different dosage regimens of capecitabine in the treatment of advanced gastrointestinal tumors

目的 比较卡培他滨不同给药方案治疗晚期消化道肿瘤患者的治疗效果。方法 选取2020年1—12月启东市人民医院/南通大学附属启东医院收治的晚期消化道肿瘤患者60例,按双盲法随机分为小剂量组和常规剂量组,每组30例。常规剂量组采用常规剂量卡培他滨治疗,小剂量组给予小剂量卡培他滨治疗,2组均持续治疗9周。比较2组近期临床疗效、不良反应发生率、临床指标变化及预后效果。结果 小剂量组患者近期总有效率为90.00%,高于常规剂量组的66.67%(χ^(2)=4.811,P=0.028);小剂量组恶心呕吐、口腔炎、白细胞计数下降、手足综合征、色素沉着发生率均低于常规剂量组(P<0.05或P<0.01);治疗9周后,2组癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原19-9(CA19-9)、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)水平与疼痛程度评分均较治疗前下降,且小剂量组上述指标低于常规剂量组(P均<0.01);小剂量组肿瘤进展时间、平均生存期长于常规剂量组,差异有统计学意义(P<0.05或P<0.01)。结论 小剂量卡培他滨在晚期消化道肿瘤治疗中效果确切,可提高治疗安全性及有效性,值得临床参考应用。

Objective Comparison of the therapeutic effects of different dosage regimens of capecitabine in the treatment of patients with advanced gastrointestinal tumors. Methods A total of 60 patients with advanced gastrointestinal tumors who were admitted to Qidong People′s Hospital/Qidong Hospital Affiliated to Nantong University from January to December 2020 were selected and randomly divided into a low-dose group and a routine-dose group according to a double-blind method, with 30 cases in each group. The routine-dose group was treated with routine-dose capecitabine, and the low-dose group was treated with low-dose capecitabine. Both groups were treated for 9 weeks. The recent clinical efficacy and the incidence of adverse reactions in the two groups were compared. The changes of clinical indicators before and after treatment in the two groups were compared. The prognosis of the two groups was compared. Results The short-term total effective rate in the low-dose group was 90.00%, which was higher than 66.67% in the conventional-dose group(χ^(2)=4.811, P=0.028). The incidences of nausea and vomiting, stomatitis, leukocyte depletion, hand-foot syndrome and pigmentation in the low-dose group were lower than those in the conventional-dose group(P<0.05 or P<0.01). After 9 weeks of treatment, the levels of carcinoembryonic antigen(CEA), alpha fetoprotein(AFP), carbohydrate antigen 19-9(CA19-9), vascular endothelial growth factor(VEGF), matrix metalloproteinase-9(MMP-9) and pain severity scores in both groups were decreased compared with those before treatment, and the above indexes in the low-dose group were lower than those in the conventional-dose group(all P<0.01). The tumor progression time and average survival time in the low-dose group were longer than those in the conventional-dose group, and the difference was statistically significant(P<0.05 or P<0.01). Conclusion Low-dose capecitabine has a definite effect in the treatment of advanced gastrointestinal tumors, which can improve the safety and effectiveness of the treatment, and is worthy of clinical reference.