全反式维甲酸联合化疗治疗中晚期胃癌临床观察  

Outcomes of chemotherapy combined with all- trans retinoid acid in treatment of medium and advanced gastric cancer

作　　者：尤振宇[1] 刘洋[1] 苏晓辉[2] 刘渤娜[1] 刘学飞[1] 

机构地区：[1]解放军第202医院肿瘤介入科,辽宁沈阳110003 [2]辽宁省肿瘤医院胃外科,辽宁沈阳110042

出　　处：《现代肿瘤医学》2015年第4期516-519,共4页Journal of Modern Oncology

基　　金：辽宁省科学技术计划项目(编号:2013225089)

摘　　要：目的:观察全反式维甲酸联合化疗对中晚期胃癌患者近期疗效、生存期及毒性反应的影响。方法:将2009年6月至2012年6月收治的204例中晚期胃癌患者随机分入试验组(102例,接受全反式维甲酸联合化疗)和对照组(102例,接受化疗和安慰剂),比较两组的近期疗效、无病生存期、总生存期、KPS评分变化和不良反应。结果:试验组的近期有效率为56.9%,对照组为39.2%,两组间差异有统计学意义(P=0.025);在高分化和中分化的患者中,试验组患者的短期有效率高于对照组(P<0.05)。试验组治疗前后的KPS评分提高率为69.6%,对照组为53.9%,两组间比较有统计学意义(P=0.021)。试验组和对照组的无病生存期分别为7.5个月和6.4个月,两组差异有统计学意义(P=0.015);试验组的中位生存期为59.8个月,对照组中位生存期为49.4个月,两组间差异有统计学意义(P=0.004)。在不良反应中,消化道反应、骨髓抑制、心脏毒性等无统计学意义;试验组高脂血症、黏膜干燥和头晕发生率均高于对照组(P=0.004;P=0.014;P=0.001)。结论:全反式维甲酸联合化疗治疗中晚期胃癌近期疗效好,可延长生存期,但增加了由全反式维甲酸引起的不良反应。Objective：To evaluate the curative efficacy of all -trans retinoid acid combined with chemotherapy on medium and advanced gastric cancer patients. Methods：Two hundred and four patients with medium and advanced gastric cancer patients were recruited in this study. They were assigned to two groups randomly：study group （n = 102; receiving all -trans retinoid acid plus chemotherapy） and control group （n = 102;receiving chemotherapy plus place- bo）. To calculate the short - term response rate （ RR）, progression free survival （ PFS ）, overall survival （OS）. The change of Karnofsky performance status score and toxicity were observed. Results： The short - term response rates of the study group and control group were 56.9% and 39.2% ,respectively（P = 0.025 ）. The short - term response rate in the patients with well differentiated adenocarcinoma and moderated differentiated adenocarcinoma of the study group was higher than that of control group（ P 〈 0.05 ）. The improving rate of KPS score in the study group was 69.6% , while that in the control was 53.9% , There was statistically difference between the two groups （P = 0. 021 ）. The PFS was 7.5 months in the study group, while which was 6.4 months in the control group ; there was a significant difference between the two groups （P = 0. 015 ）. The OS was 59.8 months in the study group, which was 49.4 months in the con- trol group, there was a significant difference between the two groups（ P = 0.004 ）. The nausea/vomiting, hematotoxici- ty, cardiotoxicity between the two groups was similar（ P 〉 0.05 ）. The ineurrence rates of hyperlipidemia, dry skin, diz- ziness of the study group were higher than those of the control group （ P = 0. 004 ; P = 0. 014 ; P = 0. 001 ）. Conclu- sion：All- trans retinoid acid combined with chemotherapy can lead to a better short -term RR, PFS and OS, but higher toxicity due to all -trans retinoid acid.

关 键 词：胃癌 化疗 全反式维甲酸 治疗效果 

分 类 号：R735.2[医药卫生—肿瘤]