Efficacy of fluorouracil combined with paclitaxel and oxaliplatin for the treatment of advanced gastric signet ring cell carcinoma  

作　　者：Mi Liu Bei Feng Na He Rong Yan Jie Qin 

机构地区：[1]Department of Gastroenterology,The First Affiliated Hospital of Xi’an Medical University,Xi’an 710077,Shaanxi Province,China [2]Department of Oncology,The Affiliated Hospital of Yan’an University,Yan’an 716000,Shaanxi Province,China [3]Department of Gastroenterology,The First Affiliated Hospital of Xi'an Medical University,Xi'an 710077,Shaanxi Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第3期69-78,共10页世界胃肠外科杂志(英文)

摘　　要：BACKGROUND Gastric signet ring cell carcinoma(GSRC)is a distinctive type of gastric cancer.It is a mucus-secreting adenocarcinoma that may progress to distant metastasis at an early stage.Because of poor differentiation,aggressive invasion,rapid progre-ssion,and other high-risk characteristics,early surgical intervention should be prioritized.AIM To explore the clinical efficacy of fluorouracil(5-FU)combined with paclitaxel and oxaliplatin for the treatment of advanced GSRC.METHODS A total of 85 patients with advanced GSRC were selected between January 2020 and June 2021 and randomly divided into a control group(n=42,receiving standard chemotherapy)and a treatment group(n=43,receiving monotherapy with oxaliplatin,5-FU,and paclitaxel).Patients in the treatment group received a 135 mg/m2 infusion of paclitaxel for 3 hours,a 400 mg/m2 infusion of calcium folate(or 200 mg/m2 of levocalcium folate)for 2 hours,and an 85 mg/m2 infusion of oxaliplatin for 2 hours.This was followed by a continuous intravenous infusion of 2200-2400 mg/m25-FU for 46 hours using a portable pump.RESULTS The treatment group showed a median survival time of 11.7 months and an objective response rate(ORR)of 32.5%,significantly higher than the control group(P<0.05).Serum carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and albumin levels were correlated with treatment effectiveness in advanced GSRC(P<0.01),but total serum protein was not correlated(P>0.05).Safety and survival were assessed in all patients.Short-term efficacy was evaluated in 66 patients,with a disease control rate of 89.4%and an ORR of 48.5%.Median progression-free survival was 7.0 months(95%confidence interval[CI]:6.85-7.15),and median overall survival was 10.6 months(95%CI:9.86-11.3).Primary grade III/IV adverse events included neutropenia(22.1%)and peripheral neurotoxicity(10.3%).CONCLUSION This treatment regimen is more effective for patients with advanced GSRC.Serum levels of CEA,CA19-9,and albumin predicted chemotherapy efficacy,while total protein concentrat

关 键 词：OXALIPLATIN Tigio Carcinoembryonic antigen Carbohydrate antigen 19-9 Advanced gastric signet ring cell carcinoma 

分 类 号：R735.2[医药卫生—肿瘤]