阿帕替尼联合替吉奥一线治疗晚期胃癌临床研究
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摘要
目的探讨阿帕替尼联合替吉奥一线治疗晚期胃癌的疗效及对血清细胞因子的影响。方法选择医院2014年2月至2016年12月收治的晚期胃癌患者97例,按随机数字表法分为观察组(49例)和对照组(48例),两组患者均给予抑酸和止吐及保肝和保肾等常规治疗。对照组患者给予替吉奥治疗,观察组患者在对照组患者治疗基础上加用阿帕替尼,均以4周为1个疗程,治疗2个疗程。结果观察组有效率为48.98%,疾病控制率为81.63%,均明显高于对照组的27.08%和62.50%(P <0.05);治疗后,观察组患者的肿瘤特异性生长因子(TSGF)、糖类抗原199(CA199)及癌胚抗原(CEA)水平均低于对照组(P <0.05),γ-干扰素(IFN-γ)和肿瘤坏死因子-α(TNF-α)水平均高于对照组(P <0.05),白细胞介素6(IL-6)和白细胞介素10(IL-10)水平均低于对照组(P <0.05);观察组患者的中位进展时间和中位生存期均明显长于对照组(P <0.05),6个月生存率和1年生存率均明显高于对照组(P <0.05);两组不良反应发生率无显著差异(P> 0.05)。结论阿帕替尼联合替吉奥对晚期胃癌患者实施一线治疗的疗效和安全性较好,可降低血清肿瘤标志物水平,改善Th_1和Th_2类细胞因子的表达及患者的生存预后。
Objective To investigate the clinical effect of apatinib combined with Tegafur,Gimeracil and Oteracil Potassium Capsules in the first-line treatment of advanced gastric cancer and its effect on serum cytokines.Methods Totally 97 patients with advanced gastric cancer admitted to our hospital from February 2014 to December 2016 were selected and divided into the observation group(49 cases) and the control group(48 cases) according to the random number table method.The patients in the two groups were given routine treatment such as acid suppression,antiemetic,liver protection and kidney protection.The patients in the control group were treated with Tegafur,Gimeracil and Oteracil Potassium Capsules,on this basis,the patients in the observation group were treated with apatinib.4 weeks as a course of treatment,both groups were treated for 2 courses.Results The effective rate was 48.98% and the disease control rate was 81.63% of the observation group,which were significantly higher than 27.08% and 62.50% of the control group(P < 0.05).After treatment,the levels of tumor-specific growth factor(TSGF),carbohydrate antigen 199(CA199) and carcinoembryonic antigen(CEA) in the observation group were lower than those in the control group(P < 0.05),the levels of interferon-γ(IFN-γ) and tumor necrosis factor-α(TNF-α) in the observation group were higher than those in the control group(P < 0.05),the levels of interleukin-6(IL-6) and interleukin-10(IL-10) in the observation group were lower than those in the control group(P <0.05).The median progression time and median survival time of the patients in the observation group were significantly longer than those in the control group(P < 0.05),and the 6-month survival rate and 1-year survival rate in the observation group were significantly higher than those in the control group(P < 0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P > 0.05).Conclusion Apatinib combined with Tegafur,Gimeracil and Oteracil Potassium Capsules are effective and safe in the treatment of advanced gastric cancer,which can reduce the level of serum tumor markers and improve the expression of Th_1 and Th_2 cytokines and survival prognosis of patients.
Objective To investigate the clinical effect of apatinib combined with Tegafur,Gimeracil and Oteracil Potassium Capsules in the first-line treatment of advanced gastric cancer and its effect on serum cytokines.Methods Totally 97 patients with advanced gastric cancer admitted to our hospital from February 2014 to December 2016 were selected and divided into the observation group(49 cases) and the control group(48 cases) according to the random number table method.The patients in the two groups were given routine treatment such as acid suppression,antiemetic,liver protection and kidney protection.The patients in the control group were treated with Tegafur,Gimeracil and Oteracil Potassium Capsules,on this basis,the patients in the observation group were treated with apatinib.4 weeks as a course of treatment,both groups were treated for 2 courses.Results The effective rate was 48.98% and the disease control rate was 81.63% of the observation group,which were significantly higher than 27.08% and 62.50% of the control group(P < 0.05).After treatment,the levels of tumor-specific growth factor(TSGF),carbohydrate antigen 199(CA199) and carcinoembryonic antigen(CEA) in the observation group were lower than those in the control group(P < 0.05),the levels of interferon-γ(IFN-γ) and tumor necrosis factor-α(TNF-α) in the observation group were higher than those in the control group(P < 0.05),the levels of interleukin-6(IL-6) and interleukin-10(IL-10) in the observation group were lower than those in the control group(P <0.05).The median progression time and median survival time of the patients in the observation group were significantly longer than those in the control group(P < 0.05),and the 6-month survival rate and 1-year survival rate in the observation group were significantly higher than those in the control group(P < 0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P > 0.05).Conclusion Apatinib combined with Tegafur,Gimeracil and Oteracil Potassium Capsules are effective and safe in the treatment of advanced gastric cancer,which can reduce the level of serum tumor markers and improve the expression of Th_1 and Th_2 cytokines and survival prognosis of patients.
引文
[1]高金平,韩涛,朴瑛,等.阿帕替尼联合替吉奥治疗老年或瘦弱患者晚期胃癌临床研究[J].临床军医杂志,2017,45(1):9-12.
[2]TENG F,XU Z,CHEN J,et al.DUSP1 induces apatinib resistance by activating the MAPK pathway in gastric cancer[J].Oncol Rep,2018,40(3):1203-1222.
[3]李进磊,王纪青,王雪,等.甲磺酸阿帕替尼与替吉奥胶囊联合经动脉化学治疗栓塞术治疗晚期胃癌的效果[J].中国临床实用医学,2018,9(2):29-31.
[4]中华人民共和国国家卫生和计划生育委员会.胃癌规范化诊疗指南(试行)[J].中国医学前沿杂志:电子版,2013,5(8):56-63.
[5]井小会.阿帕替尼联合替吉奥一线治疗老年晚期胃癌[J].中国实用医刊,2016,43(10):37-39.
[6]贺华,周美红,张勇.贝伐单抗与卡培他滨联合奥沙利铂方案对老年晚期胃癌术后血清肿瘤标志物及生活质量的影响[J].中国药业,2017,26(5):69-72.
[7]LIU X,QIN S,WANG Z,et al.Correction to:Early presence of anti-angiogenesis-related adverse events as a potential biomarker of antitumor efficacy in metastatic gastric cancer patients treated with apatinib:a cohort study[J].J Hematol Oncol,2018,11(1):5-7.
[8]YANG Y,ZHANG W,YAO J,et al.First-line treatment of apatinib in elderly patient of advanced gastric carcinoma:A case report of NGS-driven targeted therapy[J].Cancer Biol Ther,2018,19(5):355-358.
[9]SCOTT LJ.Correction to:Apatinib:A Review in Advanced Gastric Cancer and Other Advanced Cancers[J].Drugs,2018,78(7):759-760.
[10]杨宝玉,林小燕,王新利,等.阿帕替尼联合替吉奥治疗晚期胃癌效果观察[J].肿瘤研究与临床,2017,29(9):630-633.
[11]孟长婷,赵林,白春梅,等.晚期胃癌应用阿帕替尼病例报告1例[J].中国肿瘤临床,2017,44(7):354-355.
[12]马靓,赵霞,钱琦,等.阿帕替尼联合替吉奥治疗晚期胃癌的疗效观察[J].肿瘤药学,2018,8(2):174-178.
[13]MA JL,ZHANG T,SUO FZ,et al.Lysine-specific demethylase1 activation by vitamin B2 attenuates efficacy of apatinib for proliferation and migration of gastric cancer cell MGC-803[J].J Cell Biochem,2018,119(6):4957-4966.
[2]TENG F,XU Z,CHEN J,et al.DUSP1 induces apatinib resistance by activating the MAPK pathway in gastric cancer[J].Oncol Rep,2018,40(3):1203-1222.
[3]李进磊,王纪青,王雪,等.甲磺酸阿帕替尼与替吉奥胶囊联合经动脉化学治疗栓塞术治疗晚期胃癌的效果[J].中国临床实用医学,2018,9(2):29-31.
[4]中华人民共和国国家卫生和计划生育委员会.胃癌规范化诊疗指南(试行)[J].中国医学前沿杂志:电子版,2013,5(8):56-63.
[5]井小会.阿帕替尼联合替吉奥一线治疗老年晚期胃癌[J].中国实用医刊,2016,43(10):37-39.
[6]贺华,周美红,张勇.贝伐单抗与卡培他滨联合奥沙利铂方案对老年晚期胃癌术后血清肿瘤标志物及生活质量的影响[J].中国药业,2017,26(5):69-72.
[7]LIU X,QIN S,WANG Z,et al.Correction to:Early presence of anti-angiogenesis-related adverse events as a potential biomarker of antitumor efficacy in metastatic gastric cancer patients treated with apatinib:a cohort study[J].J Hematol Oncol,2018,11(1):5-7.
[8]YANG Y,ZHANG W,YAO J,et al.First-line treatment of apatinib in elderly patient of advanced gastric carcinoma:A case report of NGS-driven targeted therapy[J].Cancer Biol Ther,2018,19(5):355-358.
[9]SCOTT LJ.Correction to:Apatinib:A Review in Advanced Gastric Cancer and Other Advanced Cancers[J].Drugs,2018,78(7):759-760.
[10]杨宝玉,林小燕,王新利,等.阿帕替尼联合替吉奥治疗晚期胃癌效果观察[J].肿瘤研究与临床,2017,29(9):630-633.
[11]孟长婷,赵林,白春梅,等.晚期胃癌应用阿帕替尼病例报告1例[J].中国肿瘤临床,2017,44(7):354-355.
[12]马靓,赵霞,钱琦,等.阿帕替尼联合替吉奥治疗晚期胃癌的疗效观察[J].肿瘤药学,2018,8(2):174-178.
[13]MA JL,ZHANG T,SUO FZ,et al.Lysine-specific demethylase1 activation by vitamin B2 attenuates efficacy of apatinib for proliferation and migration of gastric cancer cell MGC-803[J].J Cell Biochem,2018,119(6):4957-4966.