晚期胃癌不同一线化疗方案治疗及生存分析  

The survival analysis for patients with advanced gastric cancer in different first-line chemotherapy regimens

作　　者：方玫玫[1] 杨钰贤[1] 李舟 江艺[1] FANG Meimei;YANG Yuxian;LI Zhou;JIANG Yi(Department of Medical Oncology, Cancer Hospital of Shantou University Medical College,Shantou Guangdong 515041, China)

机构地区：[1]汕头大学医学院附属肿瘤医院肿瘤内科,广东汕头515041

出　　处：《转化医学杂志》2019年第2期89-94,共6页Translational Medicine Journal

基　　金：2018年汕头市第一批医疗卫生科技项目(汕府科2018-37号)

摘　　要：目的晚期胃癌系统性治疗带来了显著的生存获益;然而,可选择一线治疗方案的优劣性目前仍不明确。本研究探索晚期胃癌不同一线化疗方案的疗效及生存的相关因素。方法回顾性分析汕头大学医学院附属肿瘤医院肿瘤内科2013年1月—2015年12月收治的晚期胃癌患者的相关资料,分析不同化疗方案其客观缓解率、无进展生存期和总生存期的差异性,分析预后的相关因素。结果共有87例患者入选,其中接受含奥沙利铂方案(m FOLFOX6或XELOX) 57例,接受含紫杉类方案(多西他赛或紫杉醇联合顺铂或5-氟尿嘧啶) 23例,7例接受其他化疗方案(包括卡培他滨单药、FOLFIRI及顺铂腹腔化疗等),其客观缓解率分别为25. 5%,21. 1%,0%(P=0. 047),疾病控制率分别为64. 7%,63. 2%,0%(P=0. 009);随访日期截至2016年6月30日,中位无进展生存时间分别为6. 9个月、4. 1个月、2. 1个月(P=0. 004),中位总生存时间分别为22. 6个月、5. 8个月、3. 2个月(P<0. 001);单因素Cox回归分析显示:化疗方案、化疗周期数、化疗疗效、肿瘤原发部位、化疗前有无腹膜转移与患者的预后密切相关(P<0. 05)。而多因素分析显示:化疗方案、化疗周期数、化疗前有无腹膜转移、化疗前CA19-9水平为影响预后的独立因素(P<0. 05)。结论含奥沙利铂为主方案疗效佳,可以作为晚期胃癌一线治疗的优选方案;一线化疗方案、化疗周期数、化疗前有无腹膜转移、化疗前CA19-9水平为影响预后的独立因素,治疗前腹膜转移、CA19-9升高提示预后较差。Objective It is still unclear that which chemotherapy regimen is best in first-line treatment for advanced gastric cancer. Our study tried to explore the efficacy of different first-line chemotherapy regimens for advanced gastric cancer,and to analyze the associated factors of survival.Methods A retrospective analysis of clinical and pathological data of patients with advanced gastric cancer in Cancer Hospital of Shantou University Medical College from January 2013 to December2015,to observe and analyze the difference of objective response rate,progression-free survival and overall survival in different first-line chemotherapy regimens. And we also analyzed the relationship between prognosis and its clinicopathological factors. Results Eight seven patients were enrolled into this study,57 patients( 66%) received oxaliplatin containing regimens( including m FOLFOX6 or XELOX),23 patients( 26%) received taxane containing regimen( including docetaxel or paclitaxel combined with DDP or 5-FU) and 7 patients( 8%) received other regimen group( including Capecitabine,FOLFIRI or DDP intraperitoneal chemotherapy),the objective response rate were25. 5%,21. 1% and 0% respectively( P = 0. 047),disease control rate were 64. 7%,63. 2% and0% respectively( P = 0. 009). Up to June 2016 the median progression-free survival were 6. 9 months,4. 1 months and 2. 1 months respectively( P = 0. 004),and the median overall survival were22. 6 months,5. 8 months and 3. 2 months respectively( P<0. 001). Cox regression analysis of factors affecting the prognosis of patients with advanced gastric cancer,univariate analysis showed that the first-line chemotherapy regimens,the number of chemotherapy cycles,the response of chemotherapy,primary tumor site,peritoneal metastasis before chemotherapy were statistically related with prognosis( P<0. 05). Multivariate analysis showed that the first-line chemotherapy regimen,the number of first-line chemotherapy cycles,peritoneal metastasis before chemotherapy,and elevated CA19-9 level before chemotherapy w

关 键 词：晚期胃癌 化学疗法 疗效 预后 

分 类 号：R735.2[医药卫生—肿瘤]