紫杉醇脂质体联合卡培他滨方案治疗局部进展期胃癌的疗效及循环肿瘤细胞对疗效的预测价值  

Paclitaxel liposome combined with capecitabine in locally advanced gastric cancer and the predictive value of circulating tumor cell

作　　者：苏静[1] 张冬 张晓彤 SU Jing;ZHANG Dong;ZHANG Xiaotong(Department of Oncology,Sanmenxia Central Hospital,Sanmenxia 472000,He’nan,China)

机构地区：[1]三门峡市中心医院肿瘤内科,河南三门峡4720000

出　　处：《癌症进展》2021年第6期607-610,618,共5页Oncology Progress

摘　　要：目的探讨紫杉醇脂质体联合卡培他滨方案治疗局部进展期胃癌的疗效及循环肿瘤细胞(CTC)对化疗疗效的预测价值。方法80例进展期胃癌患者均采用紫杉醇脂质体联合卡培他滨方案化疗,分析临床疗效及不良反应发生情况。依据CTC检测结果将患者分为阳性组和阴性组,分析化疗前后两组患者血清肿瘤标志物水平及无进展生存时间(PFS)、总生存时间(OS)。结果80例胃癌患者均获得疗效评价,总有效率为53.75%,疾病控制率为86.25%。总体不良反应方面,白细胞减少发生率为30.00%,1~2级占25.00%,3~4级占5.00%;血小板降低发生率为27.50%,1~2级占20.00%,3~4级占7.50%。化疗前及化疗后,阳性组患者癌胚抗原(CEA)、肿瘤相关物质(TAM)水平均高于阴性组(P﹤0.05),且两组患者化疗后CEA、TAM水平均较化疗前下降(P﹤0.05)。CTC阳性组患者中位PFS、中位OS均短于阴性组,差异均有统计学意义(P﹤0.05)。结论紫杉醇脂质体联合卡培他滨方案治疗局部进展期胃癌具有较好的疗效和安全性,CTC能够评估化疗疗效及患者预后。Objective To investigate the efficacy of paclitaxel liposome combined with capecitabine in locally advanced gastric cancer and the predictive value of circulating tumor cell(CTC).Method A total of 80 patients with advanced gastric cancer were treated with paclitaxel liposome combined with capecitabine,and the clinical efficacy and adverse reactions were analyzed.According to results of CTC test,patients were divided into positive group and negative group;the serum tumor marker levels,progression-free survival(PFS)and overall survival(OS)of the two groups before and after chemotherapy were analyzed.Result The overall response rate and disease control rate of 80 patients with gastric cancer was 53.75%and 86.25%,respectively;The incidence of leukopenia was 30.00%,with 25.00%of grade 1-2 and 5.00%of grade 3-4 events;the incidence of thrombocytopenia was 27.50%,with 20.00%of grade 1-2 and 7.50%of grade 3-4 events.Before and after chemotherapy,the levels of carcinoembryonic antigen(CEA)and tumor associated material(TAM)in the positive group were higher than those in the negative group(P<0.05);the levels of CEA and TAM in the two groups after chemotherapy were lower than those before chemotherapy(P<0.05);the median PFS and OS in the positive group were shorter than those of in negative group(P<0.05).Conclusion Paclitaxel liposome combined with capecitabine is effective and safe in locally advanced gastric cancer.CTC can evaluate the efficacy and prognosis of chemotherapy.

关 键 词：紫杉醇脂质体 卡培他滨 进展期胃癌 循环肿瘤细胞 

分 类 号：R735.2[医药卫生—肿瘤]