摘要
目的探讨曲妥珠单抗联合SOX新辅助化疗方案治疗不能切除进展期胃癌的疗效。方法选取我院2013年1月~2015年12月收治入院的不能切除的进展期胃癌患者40例作为研究对象,FISH法检测40例晚期(IV期)胃癌患者Her-2基因均为扩增,按治疗方法不同分为两组:对照组20例,采用SOX新辅助化疗治疗,观察组20例患者采用曲妥珠单抗联合SOX新辅助化疗方案治疗。所有患者至少完成2周期治疗,按照RECIST1.1标准进行疗效评价,按WHO规定的抗癌药物毒性反应分度评价不良反应。结果观察组总有效率为60.0%,对照组总有效率为35.0%,观察组疗效优于对照组,差异有统计学意义(P<0.05);观察组患者有12例患者进行了手术,其中标准D_2手术比例为83.3%(10/12),R_0切除率为83.3%(10/12)。均高于对照组患者标准D_2手术比例为57.1%(4/7),R_0切除率为71.4%(5/7),且比较差异有统计学意义(χ_2=6.027,4.128,P均<0.05);两组患者治疗后的不良反应均较轻,主要表现为I^II度的骨髓抑制、恶心、呕吐、神经毒性。其中骨髓抑制26例(65.0%),恶心、呕吐18例(45.0%),神经毒性19例(47.5%),腹泻10例(25.0%),肝功能损害7例(17.5%),心脏毒性1例(2.5%)。两组患者不良反应比较差异无统计学意义(P>0.05)。结论曲妥珠单抗联合SOX新辅助化疗方案治疗不能切除进展期胃癌是有效、安全可行的。
Objective To investigate trastuzumab combined with SOX neoadjuvant chemotherapy in the treatment of unresectable efficacy of advanced gastric cancer. Methods In our hospital from January 2013 to December 2015 in patients with advanced gastric cancer were treated unresectable admitted 40 patients as research subjects, FISH detected 40 cases of advanced（IV stage） patients with gastric cancer gene Her-2 were amplified, according to the different treatment methods are divided into two groups： a control group of 20 patients, the use of SOX neoadjuvant chemotherapy treatment, observation group, 20 patients were treated with trastuzumab combined with SOX neoadjuvant chemotherapy. All patients completed at least two cycles of treatment, according to RECIST1.1 standards for efficacy evaluation, according to WHO toxicity of anticancer drugs prescribed reaction indexing evaluation of adverse reactions. Results The total effective rate was 60.0% in the control group, the total effective rate was 35.0%, the observation group than the control group, the difference was statistically significant（P0.05）, the observation group, 12 patients underwent surgery, wherein the ratio of the standard D2 surgery 83.3%（10/12）, R0 resection rate was 83.3%（10/12）. Were higher proportion of patients with standard D2 surgery was 57.1%（4/7）, R0 resection rate was 71.4%（5/7）, and the difference was statistically significant（χ2=6.027, 4.128, P 0.05）, two groups of patients after adverse reactions were mild, mainly as I-II degree of bone marrow suppression, nausea, vomiting, and neurotoxicity. Wherein myelosuppression 26 cases（65.0%）, nausea, vomiting, 18 cases（45.0%）, neurotoxicity 19 cases（47.5%）, diarrhea in 10 cases（25.0%）, liver dysfunction 7 cases（17.5%）, cardiac toxicity 1 case（2.5%）. Two groups of patients adverse reactions was no significant difference（P0.05）. Conclusion Trastuzumab combined with SOX neoadjuvant chemotherapy for unresectable advanced gastric cancer is effective, safe and feasible.
出处
《中国继续医学教育》
2016年第15期149-151,共3页
China Continuing Medical Education
基金
上海市闵行区自然科学研究课题资助项目(项目编号:2014MHZ022)
