多西他赛、奥沙利铂、替吉奥三联化疗在局部进展期胃癌治疗中的应用研究  

Study on the application of a triple drug chemotherapy of docetaxel, oxaliplatin and S-1 in the treatment of locally advanced gastric cancer

作　　者：王宏 夏永寿 王瑛 WANG Hong;XIA Yongshou;WANG Ying(Department of Oncology;Department of Hematology,Chang＇an Hospital,Xi＇an 710016,Shaanxi,China;Department of Respiratory Medicine,Tangdou Hospital,Air Force Military Medical University,Xi＇an 710038,Shaanxi,China)

机构地区：[1]空军军医大学唐都医院肿瘤科,西安710038 [2]空军军医大学唐都医院呼吸内科,西安710038 [3]长安医院血液内科,西安710016

出　　处：《癌症进展》2018年第9期1151-1155,共5页Oncology Progress

摘　　要：目的研究多西他赛、奥沙利铂、替吉奥三联化疗在局部进展期胃癌(LAGC)治疗中的效果。方法选取178例LAGC患者,依据随机数字表法分为DSOX组(多西他赛、奥沙利铂、替吉奥)89例和DCF组(多西他赛、5-氟尿嘧啶、顺铂)89例。选择同期健康体检的健康者89例纳入对照组。观察DSOX组、DCF组患者治疗前、治疗3个周期后及对照组受试者同时间点的血清T淋巴(T)细胞、辅助性T(Th)细胞、抑制性T(Ts)细胞、细胞因子诱导的杀伤(CIK)细胞、自然杀伤(NK)细胞等免疫因子水平,血清细胞角蛋白19(CK19)、分化群105(CD105)、分化群146(CD146)水平及治疗期间的不良反应发生情况。结果 DSOX组患者的缓解率(RR)为41.57%,高于DCF组的26.97%(P﹤0.05);DSOX组患者的疾病控制率(DCR)为80.90%,明显高于DCF组的60.67%(P﹤0.01)。治疗前后,DCF组、DSOX组患者的T、Th、CIK、NK细胞水平均低于对照组,Ts细胞、CK19、CD105、CD146水平均高于对照组(P﹤0.05)。治疗后,DSOX组患者的T、Th、CIK、NK细胞水平均高于DCF组,Ts细胞水平低于DCF组(P﹤0.05)。治疗后,DSOX组患者的CK19、CD105、CD146水平均低于DCF组(P﹤0.05)。DSOX组患者的恶心呕吐、血小板减少、粒细胞减少、肝功能不全、脱发、手足综合征的发生率均低于DCF组(P﹤0.05)。结论多西他赛、奥沙利铂、替吉奥三联化疗可以有效地杀灭LAGC细胞,改善免疫失衡,降低肿瘤标志物水平,且不良反应较小,值得临床应用。Objective To study the effect of the triple drug regimen of docetaxel, oxaliplatin and tegafur, gimeracil and oteracil potassium capsules（S-1） in the treatment of locally advanced gastric cancer（LAGC）. Method 178 cases of LAGC were randomized as docetaxel, oxalipalatin and S-1（DSOX） group（89 cases） and docetaxel, 5-fluorouracil, and cisplatin（DCF） group（89 cases） using a random number table, and a total of 89 healthy subjects were selected as control group. DSOX group was given the triple drug regimen of docetaxel, oxaliplatin, and S-1 as chemotherapy, while the DCF group was treated with docetaxel, 5-fluorouracil（5-FU） and cisplatin. The levels of immune factors such as T lymphocyte（T）, helper T（Th）, suppressor T（Ts）, cytokine induced killer（CIK）, natural killer（NK） cells, as well as the serum cytokeratin 19（CK19）, cluster of differentiation 105（CD105） and cluster of differentiation 146（CD146） levels in the two study groups were observed before treatment, after 3 cycles of chemotherapy and after whole treatment courses, besides, the adverse reactions during chemotherapy were analyzed, and the control group was assessed at the same time points for the same measures. Result The response rate（RR） in the DSOX group was 41.57%, which was higher than that in the DCF group at 26.97%（P0.05）. The disease control rate（DCR） in DSOX group（80.90%） was also higher than that of DCF group（60.67%）（P0.01）. Before and after treatment, the level of T, Th, CIK and NK in DCF group and DSOX group were all higher, while Ts, CK19, CD105 AND CD146 were lower than those in control group（P0.05）, After treatment,the level of T, Th, CIK and NK in DSOX group were higher than that in DCF group, and Ts level was lower than that of DCF group（P0.05）. After treatment, the level of CK19, CD105 and CD146 of DSOX group were lower than that of DCF group（P0.05）. The incidences of nausea and vomiting, thrombocytopenia, granulocytopenia, hepatic insufficiency,

关 键 词：多西他赛 奥沙利铂 替吉奥 三联化疗 局部进展期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]