曲妥珠单抗联合SOX方案治疗进展期胃癌患者的效果

Effects of Trastuzumab combined with SOX regimen in treatment of patients with advanced gastric cancer

目的:观察曲妥珠单抗联合SOX方案治疗进展期胃癌患者的效果。方法:选取2017年12月至2020年12月该院收治的86例进展期胃癌患者进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各43例。对照组采用SOX方案(奥利沙铂+替吉奥)化疗,观察组在对照组基础上联合曲妥珠单抗治疗,两组均连续治疗4个周期。比较两组临床疗效、治疗前后肿瘤标志物[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)]水平、新生血管标志物[血管内皮生长因子(VEGF)、血管生成素-2(Ang-2)]水平、T细胞亚群指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,以及不良反应发生率。结果:治疗后,观察组客观缓解率为74.42%(32/43),高于对照组的53.49%(23/43),差异有统计学意义(P<0.05);观察组CEA、CA19-9、CA72-4、VEGF、Ang-2水平均低于对照组,差异有统计学意义(P<0.05);观察组CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05);两组恶心呕吐、腹泻、肝功能异常、骨髓抑制等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:曲妥珠单抗联合SOX方案治疗进展期胃癌患者可提高客观缓解率,降低肿瘤标志物和新生血管标志物水平,改善免疫功能,效果优于单纯SOX方案治疗。

Objective:To observe effects of Trastuzumab combined with SOX regimen in treatment of patients with advanced gastric cancer.Methods:A prospective study was conducted on 86 patients with advanced gastric cancer admitted to the hospital from December 2017 to December 2020.They were divided into observation group and control group according to the random number table method,43 cases in each.The control group was treated with SOX chemotherapy regimen,while the observation group was treated with Trastuzumab on the basis of that of the control group.Both groups were treated for 4 cycles.The clinical efficacy,the tumor marker levels[carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 72-4(CA72-4)],the neovascularization marker levels[vascular endothelial growth factor(VEGF),angiopoietin-2(Ang-2)],the T cell subset levels(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),and the incidence of adverse reactions were compared between the two groups.Results:After the treatment,the objective remission rate of the observation group was 74.42%(32/43),which was higher than 53.49%(23/43)of the control group,and the difference was statistically significant(P<0.05).The levels of CEA,CA19-9,CA72-4,VEGF and Ang-2 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the level of CD8^(+)was lower than that in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions such as nausea and vomiting,diarrhea,abnormal liver function and bone marrow suppression between the two groups(P>0.05).Conclusions:Trastuzumab combined with SOX regimen can improve the objective remission rate,reduce the levels of tumor markers and the neovascularization markers,and improve the levels of T cell subsets in the patients with advanced gastric cancer.Moreover,it is superior to single SOX regimen.