两种一线化疗方案治疗晚期胃癌的效果及对肿瘤标志物水平的影响

Effects of Two First-line Chemotherapy Regimens in the Treatment of Advanced Gastric Cancer and Their Effects on the Levels of Tumor Markers

目的:对比FLOT方案和SOX方案对于晚期胃癌一线化疗效果和肿瘤标志物水平的影响。方法:选取宿迁市第一人民医院2020年8月1日-2021年7月31日接受治疗的84例晚期胃癌患者随机分组,一组为FLOT组(42例),另一组为SOX组(42例),FLOT组给予FLOT方案(奥沙利铂+亚叶酸钙+氟尿嘧啶+紫杉醇)化疗,SOX组给予SOX方案(奥沙利铂+替吉奥胶囊)化疗,结束相关治疗后7 d比较两组临床疗效、肿瘤标志物水平、不良反应及生存率。结果:FLOT组客观缓解率(ORR)为54.76%,明显高于SOX组的33.33%(P<0.05);两组治疗后的癌胚抗原(CEA)、糖类抗原199(CA199)、组织多肽特异性抗原(TPS)水平均显著低于本组治疗前,且FLOT组均低于SOX组(P<0.05);3、4级不良反应比较:FLOT组的白细胞减少发生率高于SOX组,手足皮肤反应发生率低于SOX组(P<0.05);两组周围神经炎、呕吐、腹泻、肝功能异常比较,差异均无统计学意义(P>0.05);两组半年生存率差异无统计学意义(P>0.05);FLOT组的1年生存率高于SOX组(P<0.05)。结论:晚期胃癌一线化疗采用FLOT方案效果显著,可降低血清CEA、CA199、TPS水平,提高患者的1年生存率,耐受性良好,值得临床推广和应用。

Objective:To compare the effect of FLOT regimen and SOX regimen on first-line chemotherapy and influence of tumor marker level in advanced gastric cancer.Method:A total of 84 patients with advanced gastric cancer who received treatment in Suqian First People's Hospital from August 1st,2020 to July 31st,2021 were randomly divided into two FLOT group(42 patients)and SOX group(42 patients).FLOT group was treated with FLOT regimen(Oxaliplatin+Calcium Folinate+Fluorouracil+Paclitaxel),and SOX group was treated with SOX regimen(Oxaliplatin+Tegeol Capsules).The clinical efficacy 7 days after treatment,levels of tumor markers,adverse reactions and survival rate of the two groups were compared.Result:The objective response rate(ORR)in FLOT group was 54.76%,which was higher than 33.33%in SOX group(P<0.05).The levels of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and tissue polypeptide specific antigen(TPS)in two groups after treatment were significantly lower than those before treatment,and FLOT group were lower than those of SOX group(P<0.05).Comparison of grade 3,4 adverse reactions:the incidence of leukopenia in FLOT group was higher than that in SOX group,and the incidence of hand and foot skin reactions was lower than that in SOX group(P<0.05).There were no significant differences in peripheral neuritis,vomiting,diarrhea and abnormal liver function between the two groups(P>0.05).There was no significant difference in the half year survival rate between the two groups(P>0.05).The 1-year survival rate of FLOT group was higher than that of SOX group(P<0.05).Conclusion:FLOT regimen is effective in first-line chemotherapy of advanced gastric cancer,which can reduce the level of serum CEA,CA199,TPS,and improve the 1-year survival rate of patients,it is well tolerated and worthy of clinical promotion and application.