进展期胃癌手术患者术前两种化疗方案对治疗效果的影响  

Effect of two reoperative chemotherapy regimens on surgery therapeutic outcome in patients with advanced gastric cancer

作　　者：廖春 吴飞 陈鸣凤[1] 肖开美 罗溪 LIAO Chun;WU Fei;CHEN Mingfeng;XIAO Kaimei;LUO Xi(Department of Oncology,Deyang People's Hospital,Deyang 618000,Sichuan,China)

机构地区：[1]德阳市人民医院肿瘤科,四川德阳618000

出　　处：《贵州医科大学学报》2022年第2期234-238,共5页Journal of Guizhou Medical University

基　　金：四川省青年软件创新工程资助项目(2020111)。

摘　　要：目的观察替吉奥与雷替曲塞分别联合伊立替康术前化疗对手术后局部进展期胃癌疗效的影响。方法90例局部进展期胃癌患者中,48例接受替吉奥联合伊立替康治疗(替吉奥组),42例接受雷替曲塞联合伊立替康治疗(雷替曲塞组),两组均在化疗2个周期后复测肿瘤大小,比较两组患者化疗疗效,观察两组患者化疗前后血红蛋白水平、凝血与纤溶功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白降解产物(FDP)、D-二聚体(D-D)]及化疗不良反应;手术治疗后随访2年,比较两组患者生存率、转移及复发情况。结果替吉奥组化疗总有效率高于雷替曲塞组(P<0.05);两组患者化疗后血红蛋白水平均较化疗前降低,但替吉奥组高于雷替曲塞组(P<0.05);两组患者APTT、PT均较化疗前延长、替吉奥组长于雷替曲塞组,FDP及D-D水平均较化疗前降低及替吉奥组低于雷替曲塞组(P<0.05);两组不良反应以1~2级为主,不良反应发生率比较差异无统计学意义(P>0.05);替吉奥组2年总生存率、无局部及区域复发生存率、无远处转移生存率均高于雷替曲塞组(P<0.05)。结论局部进展期胃癌手术患者术前采用替吉奥联合伊立替康化疗方案疗效优于雷替曲塞联合伊立替康化疗方案,可延长患者生存期,减少复发转移,且不良反应可控。Objective To observe the effect of preoperative chemotherapy with irinotecan combined with tegafur or raltitrexed on surgery therapeutic efficacy in postoperative patients with locally advanced gastric cancer.Methods A total of 90 patients with locally advanced gastric cancer were collected,among which 48 cases were received tegafur combined with irinotecan(tegafur group)and 42 cases undergoing raltitrexed combined with irinotecan(raltitrexed group).The tumor sizes were re-measured after 2 cycles of chemotherapy in two groups.Chemotherapy efficacy was compared between two groups.Hemoglobin level,indexes of coagulation function and fibrinolytic function[activated partial thromboplastin time(APTT),prothrombin time(PT),fibrin degradation product(FDP),D-dimer(D-D)]before and after chemotherapy as well as adverse chemotherapy reactions were observed in two groups.The patients were followed up for 2 years after surgery.The survival rate,metastasis and relapse were compared between two groups.Results The total effective rate of chemotherapy was higher in tegafur group than that in raltitrexed group(P<0.05).The hemoglobin level of two groups after chemotherapy was reduced relative to before chemotherapy,but its level in tegafur group was higher than that in raltitrexed group(P<0.05).APTT and PT in both groups were longer than those before chemotherapy,and they were longer in tegafur group than those in raltitrexed group.After chemotherapy,the levels of FDP and D-D were reduced and lower in tegafur group than that in raltitrexed group(P<0.05).The adverse reactions in two groups were mainly classified into grades 1-2,and there was no significant difference in the incidence of adverse reactions(P>0.05).The 2-year overall survival rate,survival rate without local and regional relapse and survival rate without distant metastasis in tegafur group were higher than those in raltitrexed group(P<0.05).Conclusion Preoperative tegafur combined with irinotecan is superior to raltitrexed combined with irinotecan for patients with loca

关 键 词：替吉奥 雷替曲塞 伊立替康 局部进展期胃癌 血红蛋白 凝血功能 纤溶功能 

分 类 号：R735.2[医药卫生—肿瘤]