EGFR酷氨酸激酶抑制剂联合新辅助化疗对胃癌肝转移患者根治术切除率及预后的影响  

Effect of EGFR inhibitor combined with neoadjuvant chemotherapy on the resection rate and prognosis of gastric cancer patients with liver metastasis after radical surgery

作　　者：王秋莹[1] 刘庆玲 范春香[1] 李阁 WANG Qiu-ying;LIU Qing-ling;FAN Chun-xiang;LI Ge(Department of Oncology,Shangqiu First People's Hospital,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市第一人民医院肿瘤科,河南商丘476000

出　　处：《中国卫生工程学》2024年第1期49-52,共4页Chinese Journal of Public Health Engineering

基　　金：河南省医疗科技攻关项目(2020120212)。

摘　　要：目的 观察表皮生长因子受体(EGFR)酪氨酸激酶抑制剂联合新辅助化疗对胃癌肝转移根治术切除率及预后情况的影响。方法 选取2020年1月至2022年4月本院收治的120例胃癌肝转移患者为研究对象,结合治疗指征并在征得患者同意后将其分为对照组(50例)和观察组(70例)。对照组采用常规新辅助化疗,观察组采用EGFR酪氨酸激酶抑制剂联合新辅助化疗;比较两组患者肿瘤切除率、治疗前后血清因子变化情况、病灶缓解情况;入选患者随访12个月,比较两组远期生存情况。结果 治疗后,观察组R0切除率为82.86%(58/70),高于对照组的60.00%(30/50),R1切除率为11.43%(8/70),R2切除率为5.71%(4/70),低于对照组[24.00%(12/50)、16.00%(8/50)],差异均有统计学意义(均P<0.05)。治疗前,两组患者血清相关指标比较差异均无统计学意义(均P>0.05);治疗后,观察组胰岛素样生长因子-1(IGF-1)为(252.33±50.41)μg/L,胰岛素样生长因子-2(IGF-2)为(45.22±5.71)μg/L,均低于对照组[(277.36±50.32)μg/L、(48.92±5.33)μg/L],胰岛素样生长因子结合蛋白-3(IGFBP-3)为(1.42±0.39)μg/L,高于对照组(0.92±0.11)μg/L,差异均有统计学意义(均P<0.05)。治疗后,观察组完全缓解率(CR)为28.57%(20/70),部分缓解率(PR)为35.71%(25/70),均高于对照组[10.00%(5/50)、22.00%(11/50)],肿瘤生长率(TGR)为(35.25±8.41)%,肿瘤超进展率(HPD)为7.14%(5/70),均低于对照组[(41.35±10.62)%、24.00%(12/50)],差异均有统计学意义(均P<0.05)。随访期间,观察组中位无进展生存期(PFS)为(8.41±2.33)个月,中位总生存期(OS)为(10.85±3.44)个月,均高于对照组[(6.45±2.71)个月、(8.11±1.12)个月],差异均有统计学意义(均P<0.05)。结论 EGFR抑制剂联合新辅助化疗能提升胃癌肝转移患者的肿瘤切除率,在改善患者血清指标、促进病灶恢复、延长生存周期方面有积极意义。Objective To assess the effect of epidermal growth factor receptor(EGFR)tyrosine kinase inhibitor(TKI)combined with neoadjuvant chemotherapy on the resection rate and prognosis in gastric cancer patients with liver metastasis after radical surgery.Methods One hundred and twenty patients with gastric cancer with liver metastasis who were admit-ted to Shangqiu First People's Hospital between January 2020 and April 2022 were included,and divided into a control group(50 cases)and an observation group(70 cases)in accordance with treatment indications after obtaining patient in-formed consent,receiving the conventional neoadjuvant chemotherapy,and EGFR TKI combined with neoadjuvant chemo-therapy,respectively.The cancer resection rate,pre-and post-treatment levels of serum cytokines,and lesion relief,as well as long-term survival during a 12-month follow-up period were compared between the groups.Results After treat-ment,the observation group had higher R0 resection rate[82.86%(58/70)vs 60.00%(30/50)],and lower R1 resec-tion rate[11.43%(8/70)vs 24.00%(12/50)]and R2 resection rate[5.71%(4/70)vs 16.00%(8/50)](P<0.05).There were no statistically significant differences in pre-treatment levels of serum cytokines between the groups(P>0.05).After treatment,the observation group had lower levels of insulin-like growth factor-1(IGF-1)[(252.33±50.41)μg/L vs(277.36±50.32)μg/L]and IGF-2[(45.22±5.71)μG/L vs(48.92±5.33)μg/L],and higher level of insulin-like growth factor binding protein-3(IGFBP-3)[(1.42±0.39)μg/L vs(0.92±0.11)μg/L]than the control group(P<0.05).Compared with the control group,the observation group had higher complete response(CR)to treatment[28.57%(20/70)vs 10.00%(5/50)],partial response(PR)to treatment[35.71%(25/70)vs 22.00%(11/50)],but lower tumor growth rate(TGR)[(35.25±8.41)%vs(41.35±10.62)%]and hyperprogressive disease(HPD)rate[7.14%(5/70)vs 24.00%(12/50)](P<0.05).During the follow-up period,the observation group demonstrated longer median progression-free survival(PFS)[(8.41±2.33)months vs(6.45�

关 键 词：胃癌肝转移 表皮生长因子受体酪氨酸激酶抑制剂 新辅助化疗 肿瘤切除率 预后情况 

分 类 号：R735.2[医药卫生—肿瘤]