5-氟尿嘧啶类药物联合不同化疗方案治疗胃癌的疗效对比分析

Comparative Analysis of the Efficacy of 5-Fluorouracil Analogs Combined with Different Chemotherapeutic Regimens in the Treatment of Gastric Cancer

目的对比5-氟尿嘧啶类药物(5-Fluorouracil,5-FU)联合不同化疗方案治疗胃癌的疗效。方法选取2019年1月—2023年1月泗阳医院收治的80例胃癌患者为研究对象,按照随机数表法分为A组(n=26,多西他赛+5-FU化疗)、B组(n=26,奥沙利铂+5-FU化疗)和C组(n=28,多西他赛+奥沙利铂+5-FU化疗)。对比3组临床疗效、血清肿瘤标志物[血清癌胚抗原(Carcino-embryonic Antigen,CEA)、糖类抗原199(Cancer Associated Antigen 199,CA199)、糖类抗原125(Cancer Associated Antigen125,CA125)]水平,血清血管内皮细胞生长因子受体(Vascular Endothelial Cell Growth Factor,VEGF)水平及不良反应发生情况。结果C组胃癌缓解率60.71%和胃癌控制率(89.29%)高于A组的34.62%、65.38%及B组的38.46%、76.92%,差异有统计学意义(P均<0.05);治疗后,C组CEA、CA199、CA125水平下降幅度高于A、B组,差异有统计学意义(P均<0.05);A、B组CEA、CA199、CA125比较,差异无统计学意义(P均>0.05);治疗后,C组VEGF-A、VEGFR-1下降幅度高于A、B组,差异有统计学意义(P均<0.05);A、B组VEGF-A、VEGFR-1比较,差异无统计学意义(P均>0.05);C组白细胞减少率低于A组,神经毒性发生率高于B组,差异有统计学意义(P均<0.05)。结论5-FU联合多西他赛和奥利沙铂治疗效果优于联合单一药物,可以抑制VEGF分泌,降低肿瘤标志物水平。

Objective To compare the efficacy of 5-fluorouracil analog(5-FU)combined with different chemotherapy regimens in the treatment of gastric cancer.Methods A total of 80 gastric cancer patients admitted to Siyang Hospital from January 2019 to January 2023 were selected was the research objects divided into the group A(n=26,docetaxel+5-FU chemotherapy),group B(n=26,oxaliplatin+5-FU chemotherapy)and group C(n=28,docetaxel+oxaliplatin+5-FU chemotherapy)according to random number table method.Clinical efficacy,serum tumor markers[carcino-embryonic antigen(CEA),cancer associated antigen 199(CA199),cancer associated antigen 125(CA125)]levels,serum vascular endothelial cell growth factor(VEGF)levels,and adverse reactions were compared among the 3 groups.Results The gastric cancer remission rate(60.71%)and gastric cancer control rate(89.29%)in group C were higher than those in group A(34.62%,65.38%)and group B(38.46%,76.92%),the differences were statisti cally significant(all P<0.05).After treatment,the levels of CEA,CA199 and CA125 decreased more in group C than in groups A and B,and the differences were statistically significant(all P<0.05),and there was no statistically significant difference in CEA,CA199 and CA125 between groups A and B(all P>0.05).After treatment,the decrease of VEGF-A and VEGFR-1 in group C were higher than those in groups A and B,and the differences were statistically significant(both P<0.05),and there was no statistically significant difference in VEGF-A and VEGFR-1 between group A and group B(both P>0.05).The leukopenia rate in group C was higher than that in group A,and the incidence of neurotoxicity was lower than that in group B,and the differences were statistically significant(both P<0.05).Conclusion The therapeutic effect of 5-FU combined with docetaxel and oxaliplatin is better than that of combining single drugs,which can inhibit the secretion of VEGF and reduce the level of tumor markers.