贝伐珠单抗联合FOLFOX化疗方案对胃癌晚期患者血清CA199、CEA水平及生存期的影响
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摘要
目的探讨贝伐珠单抗联合FOLFOX化疗方案对胃癌晚期患者血清糖类抗原199(CA199)、癌胚抗原(CEA)水平及生存期的影响。方法选取我院2011年5月至2016年5月收治的胃癌晚期患者46例,采用随机数字表法将其分为对照组(n=23)与试验组(n=23)。对照组采取FOLFOX化疗方案,试验组在对照组基础上联用贝伐珠单抗。持续治疗3个周期,比较两组患者临床疗效、治疗前后血清CA199、CEA水平、毒副反应发生情况、生存情况。结果试验组治疗总有效率高于对照组(P<0.05);治疗后,两组患者血清CA199及CEA水平均低于治疗前,且试验组低于对照组(P<0.05);两组均未发生Ⅳ度毒副反应,且试验组肝肾功能异常、呕吐恶心、血红蛋白减少、白细胞减少总发生率与对照组比较,无显著差异(P>0.05);试验组中位无进展生存期长于对照组(P<0.05)。结论贝伐珠单抗联合FOLFOX化疗方案治疗胃癌晚期患者,可有效降低血清CA199及CEA水平,提高治疗效果,延长生存期限,且不会增加毒副反应发生风险。
Objective To investigate the effect of bevacizumab combined with FOLFOX chemotherapy regimen on the levels of serum carbohydrate antigen 199(CA199) and carcinoembryonic antigen(CEA) and survival time in patients with advanced gastric cancer. Methods Forty-six patients with advanced gastric cancer in our hospital from May 2011 to May 2016 were selected and divided into control group(n=23) and experimental group(n=23) according to random numbers table method. The control group was treated with FOLFOX chemotherapy regimen, and the experimental group was treated with bevacizumab on the basis of the control group. Both groups were treated for 3 cycles. The clinical efficacy, levels of serum CA199 and CEA before and after treatment, occurrence of toxic and side effects and survival status of the two groups were compared. Results The total effective rate of treatment in the experimental group was higher than that of the control group(P <0.05). After treatment, the levels of serum CA199 and CEA in the two groups were lower than those before treatment, and those in the experimental group were lower than the control group(P<0.05). There were no Ⅳ degree toxic and side effects in the two groups, and there were no significant differences in the total incidences of liver and kidney dysfunction, vomiting, nausea, hemoglobin reduction and white blood cell reduction between the experimental group and the control group(P>0.05). The median progression free survival time in the experimental group was longer than that in the control group(P<0.05). Conclusion Bevacizumab combined with FOLFOX chemotherapy regimen in treating patients with advanced gastric cancer can effectively reduce the levels of serum CA199 and CEA, improve the treatment effect and prolong the survival time. Besides, it will not increase the risk of toxic side effects.
Objective To investigate the effect of bevacizumab combined with FOLFOX chemotherapy regimen on the levels of serum carbohydrate antigen 199(CA199) and carcinoembryonic antigen(CEA) and survival time in patients with advanced gastric cancer. Methods Forty-six patients with advanced gastric cancer in our hospital from May 2011 to May 2016 were selected and divided into control group(n=23) and experimental group(n=23) according to random numbers table method. The control group was treated with FOLFOX chemotherapy regimen, and the experimental group was treated with bevacizumab on the basis of the control group. Both groups were treated for 3 cycles. The clinical efficacy, levels of serum CA199 and CEA before and after treatment, occurrence of toxic and side effects and survival status of the two groups were compared. Results The total effective rate of treatment in the experimental group was higher than that of the control group(P <0.05). After treatment, the levels of serum CA199 and CEA in the two groups were lower than those before treatment, and those in the experimental group were lower than the control group(P<0.05). There were no Ⅳ degree toxic and side effects in the two groups, and there were no significant differences in the total incidences of liver and kidney dysfunction, vomiting, nausea, hemoglobin reduction and white blood cell reduction between the experimental group and the control group(P>0.05). The median progression free survival time in the experimental group was longer than that in the control group(P<0.05). Conclusion Bevacizumab combined with FOLFOX chemotherapy regimen in treating patients with advanced gastric cancer can effectively reduce the levels of serum CA199 and CEA, improve the treatment effect and prolong the survival time. Besides, it will not increase the risk of toxic side effects.
引文
[1]张昉,陈雅敏,荆超,等.改良DCF方案与FOLFOX 4方案治疗晚期胃癌的临床疗效[J].临床肿瘤学杂志,2014,19(3):231-234.
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[3]段洪瑞,宋岩,姜晓艳.阿帕替尼联合FOLFOX化疗方案治疗晚期胃癌的疗效观察[J].中国实用医药,2017,12(28):155-157.
[4]周宁,王薇,唐勇.贝伐珠单抗联合紫杉醇脂质体方案化疗治疗晚期胃癌的临床效果[J].世界华人消化杂志,2015,23(18):2957-2960.
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[7]FERRAND FR,GONTIER E,GUYMAR S,et al.Effectiveness and safe use of modified FOLFOX-6 for metastatic gastric cancer with signet ring cell components complicated by disseminated intravascular coagulation and diffuse bone marrow carcinomatosis[J].Onkologie,2012,35(3):118-120.
[8]王海英,郑瑞鹏,姚志华,等.SOX方案与FOLFOX4方案治疗老年晚期胃癌的临床分析[J].中国老年学杂志,2015,35(6):1525-1527.
[9]习羽,牛建华,梁学奇,等.SP方案与FOLFOX4方案治疗晚期胃癌的效果比较[J].广东医学,2015,36(5):780-781.
[10]李岚.贝伐珠单抗联合化疗治疗晚期胃癌的临床效果[J].国际医药卫生导报,2014,20(24):3772-3773.
[11]胡青,肖志华.贝伐珠单抗联合多西紫杉醇、5-FU以及顺铂化疗治疗晚期胃癌的疗效观察[J].实用癌症杂志,2015,30(2):225-227.
[12]王丽红,刘迎,杜晓林.贝伐珠单抗联合化疗方案用于晚期胃癌的临床观察[J].中国药房,2016,27(23):3246-3248.
[13]陈志勇,陈珍,丘金花,等.贝伐珠单抗联合mFOLFOX6方案治疗晚期结肠癌的临床效果及对血清CEA的影响[J].中国医药科学,2017,7(10):11-14.
[14]邓峰,张茹虎,朱磊.奥沙利铂联合卡培他滨对中晚期胃癌患者术后化疗的疗效及对血清CA125、CEA、TPS、CYFRA21-1、CA19-9及T淋巴细胞亚群水平的影响[J].海南医学院学报,2016,22(17):2011-2014.
[15]沈建康,袁建明,蔡中瑞,等.CEA、CA199、CA724及HSP60在胃癌患者血清中的表达及应用价值[J].川北医学院学报,2016,31(6):848-850.
[16]张瑾,刘艳屏.贝伐珠单抗联合紫杉醇脂质体对老年晚期胃癌患者血清CEA、CA199、MMP-2及MMP-9水平的影响[J].中国老年学杂志,2018,38(5):1108-1110.
[2]TSUJI K,YASUI H,ONOZAWA Y,et al.Modified FOLFOX-6 therapy for heavily pretreated advanced gastric cancer refractory to fluorouracil,irinotecan,cisplatin and taxanes:a retrospective experimental[J].Jpn J Clin Oncol,2012,42(8):686-690.
[3]段洪瑞,宋岩,姜晓艳.阿帕替尼联合FOLFOX化疗方案治疗晚期胃癌的疗效观察[J].中国实用医药,2017,12(28):155-157.
[4]周宁,王薇,唐勇.贝伐珠单抗联合紫杉醇脂质体方案化疗治疗晚期胃癌的临床效果[J].世界华人消化杂志,2015,23(18):2957-2960.
[5]杨学宁,吴一龙.实体瘤治疗疗效评价标准--RECIST[J].循证医学,2004,4(2):85-90.
[6]潘宏铭,耿宝琴.肿瘤化疗的毒副反应和防治[M].上海科学技术出版社,2001:303-307.
[7]FERRAND FR,GONTIER E,GUYMAR S,et al.Effectiveness and safe use of modified FOLFOX-6 for metastatic gastric cancer with signet ring cell components complicated by disseminated intravascular coagulation and diffuse bone marrow carcinomatosis[J].Onkologie,2012,35(3):118-120.
[8]王海英,郑瑞鹏,姚志华,等.SOX方案与FOLFOX4方案治疗老年晚期胃癌的临床分析[J].中国老年学杂志,2015,35(6):1525-1527.
[9]习羽,牛建华,梁学奇,等.SP方案与FOLFOX4方案治疗晚期胃癌的效果比较[J].广东医学,2015,36(5):780-781.
[10]李岚.贝伐珠单抗联合化疗治疗晚期胃癌的临床效果[J].国际医药卫生导报,2014,20(24):3772-3773.
[11]胡青,肖志华.贝伐珠单抗联合多西紫杉醇、5-FU以及顺铂化疗治疗晚期胃癌的疗效观察[J].实用癌症杂志,2015,30(2):225-227.
[12]王丽红,刘迎,杜晓林.贝伐珠单抗联合化疗方案用于晚期胃癌的临床观察[J].中国药房,2016,27(23):3246-3248.
[13]陈志勇,陈珍,丘金花,等.贝伐珠单抗联合mFOLFOX6方案治疗晚期结肠癌的临床效果及对血清CEA的影响[J].中国医药科学,2017,7(10):11-14.
[14]邓峰,张茹虎,朱磊.奥沙利铂联合卡培他滨对中晚期胃癌患者术后化疗的疗效及对血清CA125、CEA、TPS、CYFRA21-1、CA19-9及T淋巴细胞亚群水平的影响[J].海南医学院学报,2016,22(17):2011-2014.
[15]沈建康,袁建明,蔡中瑞,等.CEA、CA199、CA724及HSP60在胃癌患者血清中的表达及应用价值[J].川北医学院学报,2016,31(6):848-850.
[16]张瑾,刘艳屏.贝伐珠单抗联合紫杉醇脂质体对老年晚期胃癌患者血清CEA、CA199、MMP-2及MMP-9水平的影响[J].中国老年学杂志,2018,38(5):1108-1110.