白蛋白结合型紫杉醇联合奥沙利铂和替吉奥在局部不可切除的进展期胃癌转化治疗中的应用  

Application of albumin-bound paclitaxel in combination with oxaliplatin and S-1 in conversion therapy of locally unresectable advanced gastric cancer

作　　者：刘子田 王晓阳[1] 祝新 毛佳佳[1] 刘志[1] 武群政 孙富云 姚伦锦 金明新[1] LIU Zi-tian;WANG Xiao-yang;ZHU Xin;MAO Jia-jia;LIU Zhi;WU Qun-zheng;SUN Fu-yun;YAO Lun-jin;JIN Ming-xin(Department of General Surgery,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院普外科,山东济南250012

出　　处：《中国现代普通外科进展》2021年第5期374-377,383,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:研究白蛋白结合型紫杉醇联合奥沙利铂和替吉奥在局部不可切除的进展期胃癌转化治疗的临床疗效和安全性。方法:选择2016年6月—2020年6月收治的局部不可切除的进展期胃癌患者80例为研究对象,分为对照组(n=40)和实验组(n=40)。对照组患者给予奥沙利铂+替吉奥(SOX)联合化疗方案,实验组患者给予白蛋白结合型紫杉醇联合奥沙利铂+替吉奥方案化疗,两组患者均化疗至少2个周期后评估手术可行性,达到手术条件者给予手术治疗。比较两组患者客观缓解率(ORR)、疾病控制率(DCR)、肿瘤消退分级(TRG)、R0切除率以及治疗期间药物不良反应。结果:实验组转化治疗后ORR、肿瘤总消退率、R0切除率均显著高于对照组(P<0.05);恶心呕吐及周围神经毒性发生率显著高于对照组,差异有统计学意义(P<0.05);但两组患者药物不良反应多集中在Ⅰ~Ⅱ级,经对症处理后均可缓解。结论:白蛋白结合型紫杉醇联合SOX方案转化治疗治疗局部不可切除的进展期胃癌是有效的,不良反应均可控且安全性不劣于SOX方案。Objective:To investigate the clinical efficacy and safety of albumin-bound paclitaxel combined with oxaliplatin and S-1 in the treatment of local unresectable advanced gastric cancer.Methods:A total of 80 patients with locally unresectable advanced gastric cancer admitted to our hospital from June 2016 to June 2020 were selected as study subjects, and were divided into control group(n=40) and experimental group(n=40) according to chemotherapy regimen. The control group received oxaliplatin + S-1(SOX) combined chemotherapy, while the experimental group received albumin-bound paclitaxel combined oxaliplatin +S-1 chemotherapy. After at least 2 cycles of chemotherapy, the feasibility of the operation was evaluated in the two groups, and those who met the conditions of the operation were given surgical treatment. Objective To compare the remission rate (ORR), disease control rate (DCR), tumor regression grading (TRG), R0 resection rate and adverse reactions between the two groups during treatment. Results: ORR, total tumor regression rate and R0 resection rate in the experimental group were significantly higher than those in the control group(P<0.05). The incidence of nausea was significantly higher in the neurotoxic group than in the control group(P<0.05). But two groups of adverse drug reactions in patients with relatively concentrated in Ⅰ~Ⅱ level, can reduce after symptomatic treatment.Conclusion: Albumin-bound paclitaxel combined with SOX regimen is effective in the treatment of locally unresectable advanced gastric cancer. The adverse reactions are controllable, and the security is no less than that of the SOX scheme.

关 键 词：白蛋白结合型紫杉醇 替吉奥 奥沙利铂 局部不可切除的进展期胃癌 转化治疗 

分 类 号：R735.2[医药卫生—肿瘤]