FOLFOXIRI改良方案姑息化疗治疗中老年晚期胃癌的效果

The outcome of palliative chemotherapy with the modified FOLFOXIRI regimen in the treatment of middle-aged and elderly patients with advanced gastric cancer

目的 探讨5-氟尿嘧啶/亚叶酸钙+奥沙利铂+伊立替康(FOLFOXIRI)改良方案姑息化疗治疗中老年晚期胃癌的效果。方法 选取2020年2月至2022年8月本院收治的中老年晚期胃癌患者106例为研究对象,依随机数字法分2组,对照组患者接受XELOX方案治疗;观察组患者接受FOLFOXIRI改良方案姑息化疗治疗,观察2组治疗效果,观察2组血红蛋白、血小核、胃泌素-17、免疫因子(IgG、IgM、IgA、CD_(4)/CD_(8))水平,及并发症发生情况。结果 观察组有效率、疾病控制率均高于对照组(P<0.05)。治疗后2组免疫反应指标均有所上升,且观察组IgGL、IgM、IgA、CD4/CD8,显著高于对照组(P<0.001)。观察组患者除手足综合征外,其他并发症率低于对照组(P<0.05)。结论 中老年晚期胃癌患者,采取FOLFOXIRI改良方案姑息化疗治疗,其治疗效果、病情控制率更为明显,并增强患者免疫功能,且并发症更少,值得临床借鉴。

Objective To investigate the outcome of palliative chemotherapy with the modified FOLFOXIRI regimen(folinic acid/5-fluorouracil,oxaliplatin and irinotecan)in the treatment of middle-aged and elderly patients with advanced gastric cancer.Methods A total of 106 middle-aged and elderly patients with advanced gastric cancer admitted to our hospital from February 2020 to August 2022 were selected as research objects.They were randomly divided into control group and observation group.Patients in the control group and observation group were managed by the XELOX regimen(oxaliplatin and capecitabine)and the modified FOLFOXIRI regimen,respectively.Therapeutic outcome,hemoglobin,serum nucleosome,gastrin-17(G17),immune factors(immunoglobulin G[IgG],IgM,IgA,CD4/CD8)and complications were compared between groups.Results The effective rate and disease control rate in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the immune indexes in both groups increased,and the levels of IgG,IgM,IgA and CD4/CD8 in the observation group were significantly higher than those in the control group(P<0.001).The complication rate in the observation group was significantly lower than that in the control group,except for that of hand-foot syndrome(P<0.05).Conclusion For middle-aged and elderly patients with advanced gastric cancer,a palliative chemotherapy with the modified FOLFOXIRI regimen has pronounced therapeutic outcome and disease control,which can enhance the immune function,and cause less complications.It can be used in clinical application.