白蛋白紫杉醇联合信迪利单抗治疗人表皮生长因子受体2阴性Ⅲb~Ⅳ期胃癌患者的效果与安全性

Effect and safety of albumin-paclitaxel combined with sintilimab in the treatment of stage IIIb-IV gastric cancer patients with human epidermal growth factor receptor 2 negative

目的探讨白蛋白紫杉醇联合信迪利单抗治疗人表皮生长因子受体2(HER2)阴性Ⅲb~Ⅳ期胃癌患者的效果与安全性。方法根据治疗方法的不同将80例HER2阴性Ⅲb~Ⅳ期胃癌分为观察组(n=40,白蛋白紫杉醇联合信迪利单抗治疗)和对照组(n=40,白蛋白紫杉醇治疗),比较两组患者的临床疗效、肿瘤标志物[甲胎蛋白(AFP)、糖类抗原(CA)72-4]、功能状态[卡氏功能状态(KPS)评分]、生活质量[欧洲癌症患者生存质量测定量表(EORTC QLQ-C30)]、不良反应发生情况和无进展生存期。结果两组患者的治疗总有效率比较,差异无统计学意义(P﹥0.05)。观察组患者的疾病控制率高于对照组,无进展生存期长于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者AFP、CA72-4水平均低于本组治疗前,KPS、EORTC QLQ-C30评分均高于本组治疗前,观察组患者AFP、CA72-4水平均低于对照组,KPS、EORTC QLQ-C30评分均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者乏力、高血压、蛋白尿、肝功能异常发生率均高于对照组,差异均有统计学意义(P﹤0.05)。结论白蛋白紫杉醇联合信迪利单抗治疗HER2阴性Ⅲb~Ⅳ期胃癌患者的临床疗效较好,可有效降低血清肿瘤标志物水平,提高患者的功能状态和生活质量,延长无进展生存期,但是会增加部分不良反应的发生风险,因此,临床需加大对不良反应的重视,提前预防并及时及时处理不良反应情况。

Objective To investigate the effect and safety of albumin-paclitaxel combined with sintilimab in the treatment of stage IIIb-IV gastric cancer patients with human epidermal growth factor receptor 2(HER2)negative.Method A total of 80 patients with HER2 negative IIIb-IV gastric cancer were divided into observation group(n=40,albumin-paclitaxel combined with sintilimab)and control group(n=40,albumin-paclitaxel)according to different treatment methods.The clinical efficacy,tumor marker[α-fetal protein(AFP),carbohydrate antigen(CA)72-4],functional status[Karnofsky performance status(KPS)score],quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)],incidence of adverse reactions and progression-free survival were compared between two groups.Result The total effective rate in two groups was compared,and the difference was not statistically significant(P>0.05).The disease control rate in observation group was higher than that in control group,the progression-free survival time was longer than that in control group,and the differences were statistically significant(P<0.05).After treatment,AFP and CA72-4 levels in two groups were lower than those before treatment,KPS and EORTC QLQ-C30 scores were higher than those before treatment,AFP and CA72-4 levels in observation group were lower than those in control group,KPS and EORTC QLQ-C30 scores were higher than those in control group,and the differences were statistically significant(P<0.05).The incidence rates of fatigue,hypertension,proteinuria and abnormal liver function in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).Conclusion Albumin-paclitaxel combined with sintilimab in the treatment of stage IIIb-IV gastric cancer patients with HER2 negative has good clinical efficacy,which can effectively reduce the level of serum tumor markers,improve the functional status and quality of life of patients,and extend the progression-free survival.However,it will increase the incidence of some adverse reactions.Therefore,it is necessary to pay more attention to adverse reactions,prevent in advance and deal with in time.