FOLFOX6方案初治晚期胃癌引起中性粒细胞减少与近期疗效及无进展生存期的关系研究  

Neutropenia induced by FOLFOX6 regimen in patients with advanced gastric cancer and the short-term curative effect and PFS

作　　者：宋亮[1] 王爱民[2] 林志军 SONG Liang;WANG Aimin;LIN Zhijun(Department of Outpatient;Department of Oncology,People＇s Liberation Army No.175 Hospital,Zhangzhou 363000,Fujian,China)

机构地区：[1]解放军第一七五医院(厦门大学附属东南医院)门诊部,福建漳州363000 [2]解放军第一七五医院(厦门大学附属东南医院)肿瘤内科,福建漳州363000

出　　处：《癌症进展》2018年第7期893-896,共4页Oncology Progress

摘　　要：目的探讨FOLFOX6方案初治晚期胃癌引起中性粒细胞减少与近期疗效及预后的关系。方法回顾性分析使用FOLFOX6方案初治的160例晚期胃癌患者的临床资料,参照常见不良反应判定标准NCl-CTCAE4.0版,将所有患者根据中性粒细胞减少情况分为G_0组、G_(1~2)组、G_3组及G_4组,分别为22、73、42及23例。比较不同组别临床疗效及无进展生存期(PFS),并分析PFS的影响因素。结果 4组患者临床有效率比较,差异有统计学意义(χ~2=18.872,P﹤0.05),其中各组有效率分别为:G_(1~2)组76.71%(56/73),G_3组54.76%(23/42),G_4组43.48%(10/23),G_0组31.82%(7/22),G_(1~2)组﹥G_3组﹥G_4组﹥G_0组。4组患者PFS比较,差异有统计学意义(P﹤0.05),其中G_(1~2)组﹥G_3组﹥G_4组﹥G_0组。多因素分析结果显示,是否远处转移、转移部位个数及中性粒细胞减少分级为晚期胃癌患者PFS的独立影响因素。结论 FOLFOX6方案初治晚期胃癌具有良好的临床疗效和预后,与中性粒细胞减少情况密切相关;动态监测中性粒细胞有利于早期判断疗效及预后,并适时调整方案。Objective To explore the relationship between chemotherapy-induced neutropenia caused by FOLFOX6 and the short-term effect as well as the progression-free survival（PFS） in patients with advanced gastric cancer. Method The clinical data of 160 cases with advanced gastric cancer using FOLFOX6 as initial treatment were used for retrospective analysis. According to the National Cancer Institute Common Toxicity Criteria（NCI-CTCAE） 4.0, all subjects were stratified into 4 groups： G_0, G_（1-2）, G_3 and G_4 by the degree of neutropenia, with 22 cases, 73 cases, 42 cases and 23 cases in each, respectively. The clinical effect and PFS of these groups were compared and analyzed. Result The clinical response rate in the four groups was of statistically significant differences（χ~2=18.872, P〈0.05）, and was as follows： group G_（1-2）76.71%（56/73）, group G_354.76%（23/42）, group G_443.48%（10/23）, group G_031.82%（7/22）, with G_（1-2）〉G_3〉G_4〉G_0.The difference of PFS in the four groups was statistically significant（P〈0.05）, and was G_（1-2）〉G_3〉G_4〉G_0; the multivariate analysis showed that, distant metastasis, number of metastatic sites and grade of neutrophils were independent factors of PFS in patients with advanced gastric cancer. Conclusion FOLFOX6 regimen is clinically effective, with good prognosis in the treatment of advanced gastric cancer, and is closely related to neutropenia; dynamic monitoring of neutrophenia level is conducive for early judgement of efficacy and prognosis, facilitating timely modification of the regimen.

关 键 词：晚期胃癌 FOLFOX6方案 疗效 中性粒细胞 不良反应 预后 

分 类 号：R735.7[医药卫生—肿瘤]