HER2阳性胃癌患者时辰化疗与常规化疗的疗效观察

Therapeutic effect of chronomodulated chemotherapy and routine chemotherapy in patients with HER2 positive gastric cancer

目的:探讨曲妥珠单抗联合FOLFOX6时辰化疗在HER2阳性晚期转移性胃癌中的应用价值。方法:回顾性分析70例HER2阳性晚期转移性胃癌患者的临床资料,根据用药方式的不同把患者分为对照组和观察组,每组各35例;对照组患者采用曲妥珠单抗联合FOLFOX6常规化疗,观察组患者采用曲妥珠单抗联合FOLFOX6时辰化疗,对比两组患者的疗效、不良反应、细胞免疫功能指标和生活质量。结果:两组患者的一般资料和疗效比较,差异无统计学意义(P>0.05);观察组的寒战或发热、皮疹、消化道反应、周围神经毒性、骨髓抑制的发生率低于对照组(P<0.05);观察组治疗后的CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均高于对照组(P<0.05);观察组治疗后的KPS评分高于对照组(P<0.05)。结论:曲妥珠单抗联合FOLFOX6时辰化疗治疗HER2阳性晚期转移性胃癌可降低不良反应发生率,改善细胞免疫功能,减轻化疗对患者生活质量的影响。

Objective:To investigate the application value of trastuzumab combined with FOLFOX6 chronomodulated chemotherapy for patients with HER2 positive advanced metastatic gastric cancer.Methods:The clinical data of 70 patients with HER2 positive advanced metastatic gastric cancer were analyzed retrospectively.According to different administration methods,the patients were divided into control group and observation group,with 35 cases in each group.The control group was treated with trastuzumab combined with FOLFOX6 conventional chemotherapy,while the observation group was treated with trastuzumab combined with FOLFOX6 chronomodulated chemotherapy.The curative effect,adverse reactions,cellular immune function indexes and quality of life of the two groups were compared.Results:There was no significant difference between the general data and therapeutic effects of the two groups(P>0.05).The incidence of shivering or fever,rash,gastrointestinal reaction,peripheral neurotoxicity and bone marrow suppression in the observation group were significantly lower than those in the control group(P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)of the observation group were significantly higher than those of the control group(P<0.05).The KPS score of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Treatment of HER2 positive advanced metastatic gastric cancer with trastuzumab combined with FOLFOX6 chronomodulated chemotherapy can reduce the incidence of adverse reactions,improve cellular immune function and reduce the impact of chemotherapy on the quality of life of patients.