多西他赛腹腔灌注联合SOX方案化疗与DOS方案化疗对晚期胃癌伴癌性腹水患者生活质量的影响比较

Comparison of the effect of docetaxel intraperitoneal perfusion combined with SOX chemotherapy and DOS chemotherapy on the quality of life of patients with advanced gastric cancer with cancerous ascites

目的比较多西他赛腹腔灌注联合SOX方案化疗与DOS方案化疗对晚期胃癌伴癌性腹水患者生活质量的影响。方法选取2016年1月—2018年1月广西医科大学第一附属医院收治的晚期胃癌伴癌性腹水的患者78例,按1∶1的比例随机分为D-SOX组(双通路模式)和DOS组(传统模式),每组39例。D-SOX组腹腔灌注多西他赛联合SOX方案化疗,DOS组采取多西他赛、奥沙利铂、替吉奥传统模式方案化疗。2组均以21 d为1个周期,每2个周期评估疗效,化疗2~8周期。通过EORTC生活质量测定量表QLQ-C30与QLQ-STO22对2组最佳生活质量改善、改善程度的差异及恶化风险等进行评估。结果D-SOX组中功能量表包括躯体功能、社会功能以及症状量表中与腹水导致相关的症状均有明确改善。特别是在呼吸困难、吞咽困难领域、进食受限领域、口干及疼痛方面,D-SOX组在延缓恶化时间方面较DOS组有明显优势(HR:0.48~0.54)。结论多西他赛腹腔灌注联合SOX方案化疗较DOS方案化疗有更好的生活质量改善优势,对患者体力改善、症状缓解及延缓恶化均有积极作用。

Objective To compare the effect of docetaxel intraperitoneal perfusion combined with SOX chemotherapy and DOS chemotherapy on the quality of life of patients with advanced gastric cancer with cancerous ascites.Methods A total of 78 patients with advanced gastric cancer with cancerous ascites admitted to the First Affiliated Hospital of Guangxi Medical University from January 2016 to January 2018 were randomly divided into the D-SOX group(dual pathway mode)and the DOS group(traditional mode)in a 1∶1 ratio,with 39 cases in each group.The D-SOX group received docetaxel intraperitoneal perfusion combined with SOX chemotherapy,while the DOS group received traditional mode chemotherapy with docetaxel,oxaliplatin,and TS-1.The two groups were evaluated for efficacy every 2 cycles of 21 days,with chemotherapy lasting 2 to 8 cycles.The best quality of life improvement,differences in degree of improvement,and the risk of deterioration between the two groups were assessed using the EORTC quality of life measurement scale QLQ-C30 and QLQ-STO22.Results The functional scales in D-SOX group,including physical function,social function and symptoms related to ascites in the symptom scale,were significantly improved.Especially in difficulty breathing,difficulty swallowing area,restricted eating area,dry mouth and pain,the D-SOX group had obvious advantages over the DOS group in delaying the deterioration time(HR:from 0.48 to 0.54).Conclusion The combination of docetaxel intraperitoneal perfusion combined with SOX chemotherapy has a better advantage in improving quality of life compared to DOS chemotherapy,and plays a positive role in improving physical strength,relieving symptoms and delaying deterioration.