FOLFOX6方案与XELOX方案治疗胃癌的临床对比研究

Clinical Comparative Study of FOLFOX6 Regimen and XELOX Regimen in the Treatment of Gastric Cancer

目的 :研究FOLFOX6方案与XELOX方案治疗胃癌的临床价值。方法 :选取我院收治的胃癌患者82例,并按照治疗方法不同分为XELOX组和FOLFOX6组,各41例。XELOX组采用奥沙利铂静脉注射(d1,130 mg/m^2)与卡培他滨片口服(1 000 mg/m^2,tid,第1~14 d)。FOLFOX6组采用奥沙利铂静脉注射(d1,80 mg/m^2)、左亚叶酸钙静脉注射(d1, 200 mg/m^2)、5-氟尿嘧啶静脉注射(d1,400 mg/m^2),并持续泵入5-氟尿嘧啶(2400 mg/m^2)46 h。比较两组近期疗效及不良反应发生情况,同时比较两组治疗前后血管内皮生长因子(VEGF)的变化情况。结果:两组近期总有效率比较,差异无统计学意义(P> 0.05);治疗后两组VEGFR-1、VEGF-A低于治疗前,VEGF-D高于治疗前,差异有统计学意义(P <0.01),但两组比较差异无统计学意义(P> 0.05);FOLFOX6组肾功能异常发生率高于XELOX组,手足综合征发生率低于XELOX组,差异有统计学意义(P <0.01)。结论:FOLFOX6与XELOX化疗方案治疗胃癌均疗效显著,可调节患者血清中VEGF表达水平,但应及时检测化疗期间不良反应以做出相应的方案调整,使化疗顺利进行。

Objective:To study the clinical value of FOLFOX6 regimen and XELOX regimen in the treatment of gastric cancer.Methods:82 patients with gastric cancer admitted to our hospital were selected and divided into an XELOX group and an FOLFOX6 group according to different treatment methods,41 cases each.The patients in the XELOX group were treated with oxaliplatin via intravenous injection(d1,130 mg/m^2)and capecitabine tablets via oral administration(1 000 mg/m^2,tid,the 1 st to the 14 th day),and the patients in the FOLFOX6 group were treated with oxaliplatin via intravenous injection(d1,80 mg/m^2),calcium levofolinate via intravenous injection(d1,200 mg/m^2),5-fluorouracil via intravenous injection(d1,400 mg/m^2)and 5-fluorouracil via continuous pumping(2 400 mg/m^2)for 46 h.The short-term efficacy and adverse reactions were compared between the two groups,and the changes in vascular endothelial growth factor(VEGF)before and after treatment in the two groups were compared.Results:There was no statistically significant difference in the total effective rate between the two groups(P>0.05).The levels of VEGFR-1 and VEGF-A after treatment were lower than those before treatment in the two groups,while the level of VEGF-D was higher than that before treatment,with statistically significant differences(P<0.01),but the difference between the two groups was not statistically significant(P>0.05).The incidence of renal dysfunction in the FOLFOX6 group was higher than that in the XELOX group,while the incidence of hand-foot syndromes was lower than that in the XELOX group,with statistically significant differences(P<0.01).Conclusion:FOLFOX6 and XELOX chemotherapy regimens are significantly effective in the treatment of gastric cancer,which can regulate the expression level of VEGF in serum.However,the adverse reactions during chemotherapy should be detected in time to make corresponding regimen adjustments,so that the chemotherapy can proceeded smoothly.