恩度联合改良FOLFOX方案对晚期胃癌的疗效和安全性  

Efficacy and safety of endostar combined with a modified FOLFOX regimen for advanced gastric cancer

作　　者：黄世芬 杨景茹[2] 燕冰雪 赵成鹏[2] 陈蕊[2] 张涛[2] 汪泳[3] 赵达[2] 令晓玲[2] Huang Shi-fen;Yang Jing-ru;Yan Bing-xue;Zhao Cheng-peng;Chen Rui;Zhang Tao;Wang Yong;Zhao Da;Ling Xiao-ling(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,Gansu,China;Department of Oncology,The First Hospital of Lanzhou University,Lanzhou 730000,Gansu,China;The 940th Hospital of Joint Logistics Support Force of People's Liberation Army,Lanzhou 730050,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院肿瘤科,甘肃兰州730000 [3]中国人民解放军联勤保障部队第九四○医院,甘肃兰州730050

出　　处：《兰州大学学报（医学版）》2020年第4期51-57,共7页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃卫生行业科技计划管理项目(GWGL2010-20);甘肃省自然科学基金资助项目(1506RJZA310)。

摘　　要：目的评价重组人血管内皮抑制素(恩度)联合改良FOLFOX(mFOLFOX)方案在晚期胃癌和晚期胃食管交界部癌的疗效和安全性,分析与治疗效果相关的潜在影响因素。方法纳入兰州大学第一医院肿瘤科2013年6月—2017年2月收治的晚期胃癌或晚期胃食管交界部癌患者52例。所有患者接受恩度联合改良FOLFOX方案,每3周化疗1次,直至疾病进展或不可耐受的毒副反应发生。分析恩度联合改良FOLFOX方案的有效率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS)以及不良反应发生情况。结果52例患者均完成至少2周期的恩度联合改良FOLFOX方案,2周期后近期疗效评价,完全缓解为2例(3.85%),部分缓解为19例(36.5%),疾病稳定为14例(26.9%),疾病进展为17例(32.7%);DCR=67.3%(35/52),ORR=40.4%(21/52)。远期疗效评价,52例患者的中位PFS为6.0个月(95%CI:[5.183,6.817]),中位OS为10.9个月(95%CI:[9.435,12.365])。亚组分析显示晚期胃食管交界部癌的疗效略低于晚期胃癌。常见的不良事件包括骨髓抑制、消化道反应、周围神经病变等。3、4级不良事件的发生率是周围神经病变15.4%(8/52)、中性粒细胞减少23.1%(12/52)、血小板减少9.6%(5/52)、腹泻5.8%(3/52)、恶心5.8%(3/52)和呕吐3.84%(2/52)。结论恩度联合改良FOLFOX方案治疗晚期胃癌和晚期胃食管交界部癌均具有一定的疗效,化疗相关不良反应尚可耐受,2组差异无统计学意义。Objective To evaluate the efficacy and safety of recombinant human endostatin(Endo)combined with a modified FOLFOX regimen in advanced gastric cancer and advanced gastroesophageal junction cancer,and to explore the potential influencing factors related to treatment effect.Methods Fifty-two patients with advanced gastric cancer or advanced gastroesophageal junction cancer treated in Department of Oncology of the First Hospital of Lanzhou University from June 2013 to February 2017 were included.All the patients were administrated with Endo in combination with modified FOLFOX regimen every 3 weeks,until disease progression or intolerable toxicities occurred.The objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS)and adverse events were analyzed.Results Fifty-two patients completed at least 2 cycles of Endo combined with modified FOLFOX chemotherapy.After 2 cycles,the short-term efficacy evaluation showed that the complete response occurred in 2 cases(3.85%),the partial response in 19 cases(36.5%),stable disease in 14 cases(26.9%)and progression disease in 17 cases(32.7%);DCR was 67.3%(35/52)and ORR 40.4%(21/52).In the long-term efficacy evaluation,median PFS was 6.0 months(95%CI:[5.183,6.817])and median OS was 10.9 months(95%CI:[9.435,12.365])in fiftytwo patients.A subgroup analysis showed that the efficacy of advanced gastroesophageal junction cancer was slightly lower than that of advanced gastric cancer.Common adverse events included bone marrow suppression,gastrointestinal reaction and peripheral neuropathy.The incidence of grade 3 and 4 adverse events was peripheral neuropathy 15.4%(8/52),neutropenia 23.1%(12/52),thrombocytopenia 9.6%(5/52),diarrhea 5.8%(3/52),nausea 5.8%(3/52)and vomiting 3.84%(2/52).Conclusion Endo combined with modified FOLFOX regimen had a certain effect in treating advanced gastric cancer and advanced gastroesophageal junction cancer,treatment-related adverse reactions were still tolerable,and no significant difference appeared between

关 键 词：重组人血管内皮抑制素 改良FOLFOX方案 晚期胃癌 有效率 无进展生存期 总生存期 

分 类 号：R593.22[医药卫生—内科学]