吉西他滨联合替吉奥或顺铂在治疗晚期胆囊癌中的疗效评估  

Efficacy Evaluation on Gemcitabine Combined with S-1 or Cisplatin in the Treatment of Advanced Gallbladder Cancer

作　　者：王志平[1] 刘霞 罗娟 WANG Zhiping;LIU Xia;LUO Juan(Department of Surgery, Leshan traditional Chinese medicine hospital, Leshan, Sichuan, 614000, China;Department of General surgery, Leshan traditional Chinese medicine hospital, Leshan, Sichuan, 614000, China;Department of Gastroenterology, Mount Emei Fo Guang hospital, Leshan, Sichuan, 614200, China)

机构地区：[1]乐山市中医医院外一科,四川乐山614000 [2]乐山市中医医院普外科,四川乐山614000 [3]峨眉山佛光医院消化内科,四川乐山614200

出　　处：《肿瘤药学》2019年第2期256-260,266,共6页Anti-Tumor Pharmacy

基　　金：四川省卫生厅科研基金项目(150178)

摘　　要：目的探讨吉西他滨+替吉奥化疗与吉西他滨+顺铂化疗治疗晚期胆囊癌的效果及对血清肿瘤标志物的影响。方法选取2011年1月-2016年2月我院收治的78例晚期胆囊癌患者作为研究对象。所有患者均给予姑息性手术治疗,术后根据治疗方案不同分为治疗组(39例)和对照组(39例)。治疗组采取吉西他滨+替吉奥化疗方案,对照组采取吉西他滨+顺铂化疗方案治疗。对比两组患者的近期疗效、血清肿瘤标志物水平、血清生长因子水平、毒性反应及生存状况。结果治疗组总缓解率、疾病控制率与对照组比较,差异均无统计学意义(P>0.05);治疗后,两组患者血清肿瘤标志物β2-微球蛋白(β2-MG)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、甲胎蛋白(AFP)水平均明显低于治疗前(P<0.05),且治疗组均显著低于对照组(P<0.05);两组患者血管内皮生长因子(VEGF)、基质金属蛋白酶-1(MMP-1)、碱性成纤维细胞生长因子(FGF)水平均显著低于治疗前(P<0.05)),且治疗组均显著低于对照组(P<0.05));治疗组患者Ⅲ-Ⅳ度中性粒细胞减少、恶心呕吐的发生率均显著低于对照组(P<0.05);治疗组患者中位生存时间、总生存时间显著长于对照组,生存率显著高于对照组,差异均有统计学意义(P<0.05)。结论采用吉西他滨+替吉奥化疗方案治疗晚期胆囊癌的近期疗效与吉西他滨+顺铂化疗方案相当,但能明显改善患者血清肿瘤标志物及血清生长因子水平,显著减轻毒性反应,并在一定程度上延长生存期。Objective To investigate the effects of gemcitabine plus S-1 chemotherapy vs. gemcitabine plus cisplatin chemotherapy on advanced gallbladder cancer and its influence on serum tumor markers. Methods 78 patients with advanced gallbladder carcinoma in our hospital between January 2011 and February 2016 were selected as the research subjects. All patients were treated with palliative surgery.Then they were divided into treatment group(n=39) and control group(n=39) according to different treatment schemes. The treatment group was treated with gemcitabine plus S-1, while the control group was treated with gemcitabine plus cisplatin. The short-term effect, levels of serum tumor markers and serum growth factors, toxic reactions and survival status were compared between the two groups. Results The total remission rate and disease control rate did not have significant difference between the two groups(P>0.05). After treatment, the serum levels of β2-microglobulin(β2-MG), carbohydrate antigen 19-9(CA19-9), carcinoembryonic antigen(CEA), and alpha fetoprotein(AFP) in the two groups were significantly lower than those before treatment(P<0.05). Moreover, after treatment, they were even lower in treatment group than in control group(P<0.05). As for the serum levels of vascular endothelial growth factor(VEGF), matrix metalloproteinase-1(MMP-1),and basic fibroblast growth factor(FGF), they were found after treatment significantly lower than before treatment(P<0.05), and were significantly lower in treatment group than in control group after treatment(P<0.05). In addition, the incidence rate of grade Ⅲ-Ⅳ toxic reactions in neutrophils, nausea and vomiting in the treatment group was lower than in the control group(P<0.05). The median progression free time and median overall survival time were longer and survival rate were higher in the treatment group than in the control group(P<0.05).Conclusion The short-term efficacy of gemcitabine plus S-1 is similar to that of gemcitabine plus cisplatin in the treatment of advanced gallb

关 键 词：姑息性手术 吉西他滨 替吉奥 胆囊癌 血清肿瘤标志物 

分 类 号：R735.8[医药卫生—肿瘤]