榄香烯联合SOX方案治疗晚期转移性胃癌的临床效果与安全性  

Efficacy and safety of elemene combined with SOX in the treatment of advanced metastatic gastric cancer

作　　者：钱烨[1] 张燕[1] 鲁小敏[1] 吉浩明[1] QIAN Ye;ZHANG Yan;LU Xiao-min;JI Hao-ming(Department of Oncology, Haian People's Hospital Affiliated to Nantong University, Nantong 226600, Jiangsu, China)

机构地区：[1]南通大学附属海安市人民医院肿瘤科

出　　处：《海南医学院学报》2020年第2期117-121,125,共6页Journal of Hainan Medical University

基　　金：吴阶平医学基金会项目(320.3750.18075)~~

摘　　要：目的探讨榄香烯联合替吉奥/奥沙利铂(S-1/oxsliplatin,SOX)方案对晚期转移性胃癌患者的治疗效果,并对该化疗方案的安全性进行分析评价,为临床治疗提供新思路。方法选取71例晚期转移性胃癌患者为研究对象,随机分为单一应用SOX方案的对照组与榄香烯联合SOX方案的观察组,通过RECIST1.1评分和生存曲线对比两组近期和远期的治疗效果,比较两组肿瘤标志物、血清学指标和不良反应的差异。结果观察组的客观缓解率(ORR)和临床获益率(CBR)高于对照组(χ^2=5.161,P=0.031;χ^2=5.124,P=0.037);治疗后观察组血清CEA、CA-199、IGF-1、MMP-9、IL-2和IFN-γ水平均较对照组有显著改善(P<0.05);对比两组不良反应发现,观察组白细胞下降程度、贫血、乏力、恶心呕吐的发生比例均低于对照组(P<0.05);观察组的中位肿瘤进展时间(7.1个月,95%可信区间为4.037~10.248)和中位总生存时间(8.8个月,95%可信区间为6.634~10.907)显著高于对照组中位肿瘤进展时间(4.9个月,95%可信区间为2.324~6.839)和中位总生存时间(6.5个月,95%可信区间为5.007~7.638),差异均有统计学意义(P=0.001,P=0.026)。结论榄香烯联合SOX方案对晚期转移性胃癌患者具有较高的近期和远期疗效,且其毒副作用较少,安全性较高,具有一定的临床推广意义。Objective To explore the therapeutic effect of elemene combined with S-1/oxaliplatin(SOX)in the treatment of advanced metastatic gastric cancer,and to analyze and evaluate the safety of the chemotherapy,so as to provide new ideas for clinical treatment.Methods A total of 71 patients with advanced metastatic gastric cancer from April 2015 to April 2018 were randomly divided into two groups the control group treated with SOX alone and the observation group treated with elemene combined SOX.The short-term and long-term therapeutic effects of the two groups were compared by the RECIST1.1 score and survival curve,and the differences of tumor markers,serological indicators and adverse reactions between the two groups were compared.Results the objective remission rate(ORR)and clinical benefit rate(CBR)of the observation group were significantly higher than those of the control group(χ^2=5.161,P=0.031;χ^2=5.124,P=0.037);after treatment,the serum CEA,CA-199,IGF-1,MMP-9,IL-2 and IFN-γlevels of the observation group were significantly improved compared with those of the control group(P<0.05).In terms of adverse effect,the incidence of leucopenia,anemia,asthenia,nausea and vomiting in the observation group was significantly lower than that in the control group(P<0.05).The median tumor progression time(7.1 months,95%CI=4.037-10.248)and median total survival time(8.8 months,95%CI=6.634-10.907)in the observation group were significantly higher than those in the control group(4.9 months,95%CI=2.324-6.839 and 6.5 months,95%CI=5.007-7.638)with statistically significant difference(P=0.001 and P=0.026,respectively).Conclusion Elemene combined with SOX has a high short-term and long-term efficacy in patients with advanced metastatic gastric cancer,with less side effects and high safety,which has a certain clinical significance.

关 键 词：榄香烯 替吉奥 奥沙利铂 晚期转移性胃癌 疗效 安全性 

分 类 号：R735.2[医药卫生—肿瘤]