甲磺酸阿帕替尼联合XELOX方案应用于晚期胃癌治疗中对患者外周血miR-34a、CA-199、CEA水平及生存的影响  

Effect of Apatinib Mesylate Combined with XELOX Regimen on Peripheral Blood Levels of miR-34a,CA-199,CEA,and Quality of Life in Patients with Advanced Gastric Cancer

作　　者：李洁 LI Jie(Yongcheng People's Hospital,Yongcheng Henan 476600,China.)

机构地区：[1]永城市人民医院,河南永城476600

出　　处：《药品评价》2024年第11期1332-1336,共5页Drug Evaluation

摘　　要：目的 探究甲磺酸阿帕替尼在晚期胃癌一线XELOX方案治疗中的应用及对外周血mi R-34a、糖类抗原199(CA199)、癌胚抗原(CEA)水平和生存质量的影响。方法 选择2020年1月至2023年1月87例晚期胃癌患者,随机数字表法对患者进行分组。对照组行一线XELOX方案治疗,试验组在对照组基础上加用甲磺酸阿帕替尼,疗程为两个周期,并于第二个周期结束后对患者的治疗效果进行评估,并记录患者外周血mi R-34a、CA-199、CEA水平,并比较患者的生存质量及生存状况,记录组间不良反应的发生情况。结果 试验组治疗总有效率高于对照组,且临床控制率高于对照组(P<0.05)。治疗前,两组mi R-34a、CA-199、CEA水平差异无统计学意义(P>0.05);治疗后两组的mi R-34a水平升高,且试验组高于对照组;治疗后CA-199、CEA水平均较治疗前降低,且试验组低于对照组(P<0.05)。治疗前两组间生活质量调查问卷评分差异无统计学意义(P>0.05),治疗后两组的疲倦评分均较治疗前降低,且试验组低于对照组(P<0.05);两组的认知、躯体、角色、情绪、社会功能评分、恶心呕吐评分较治疗前升高,疼痛评分较治疗前降低,但治疗后组间比较差异无统计学意义(P>0.05)。对照组和试验组的中位生存时间分别为10.25个月(95%CI:0.644~15.341)、14.56个月(95%CI:0.689~19.677),试验组的中位生存时间高于对照组(P<0.05)。两组腹泻、恶心呕吐、白细胞下降、血小板下降、肝功异常、口腔黏膜炎的发生率差异无统计学意义(P>0.05)。结论 晚期胃癌采用甲磺酸阿帕替尼联合XELOX方案治疗具有良好的疗效,改善相关生物标志物水平,并延长患者生存时间,同时不会增加不良反应。Objective To explore the application of apatinib mesylate combined with the first-line XELOX regimen for the treatment of advanced gastric cancer and its effects on peripheral blood levels of miR-34a,carbohydrate antigen 199(CA-199),carcinoembryonic antigen(CEA),and quality of life.Methods A study was conducted on 87 patients with advanced gastric cancer treated from January 2020 to January 2023,patients were randomly divided into two groups using a random number table method.The control group received first-line XELOX regimen treatment,and the experimental group received apatinib mesylate combined with the XELOX regimen,the treatment course lasted for two cycles.The therapeutic effect was evaluated at the end of the second cycle.Peripheral blood levels of miR-34a,CA-199,and CEA were recorded,and the quality of life and survival status of patients were compared between the two groups.The incidence of adverse reactions was also recorded.Results The overall treatment efficacy rate and clinical control rate in the experimental group were higher than those in the control group(P<0.05).Before treatment,there were no differences in miR-34a,CA-199,and CEA levels between the two groups(P>0.05);after treatment,miR-34a levels increased in both groups,with the experimental group showing higher levels than the control group;CA-199 and CEA levels decreased after treatment,with lower levels in the experimental group compared to the control group(P<0.05).There was no significant difference in QOL scores between the two groups before treatment(P>0.05);after treatment,fatigue scores decreased in both groups,with lower scores in the experimental group(P<0.05);cognitive,physical,role,emotion and social functioning scores,and nausea/vomiting scores increased after treatment,and pain scores decreased compared to before treatment,but there were no differences between the groups after treatment(P>0.05).The median survival times were 10.25 months(95%CI:0.644~15.341)in the control group and 14.56 months(95%CI:0.689~19.677)in the experime

关 键 词：甲磺酸阿帕替尼 晚期胃癌 XELOX方案 疗效 糖类抗原199 癌胚抗原 

分 类 号：R73[医药卫生—肿瘤]