贝伐珠单抗联合紫杉醇脂质体+替吉奥治疗中晚期胃癌的临床研究

许震 左云 卢玮冬

[摘要] 目的 研究貝伐珠单抗联合紫杉醇脂质体+替吉奥治疗中晚期胃癌的临床效果。 方法 选择2012年4月～2017年12月于江苏省张家港市第一人民医院肿瘤科接受治疗的90例中晚期胃癌患者，按照不同治疗方式分成研究组和对照组，每组45例。对照组予以紫杉醇脂质体联合替吉奥治疗，研究组在对照组的基础上加用贝伐珠单抗治疗。比较两组临床疗效，血清糖类抗原724（CA724）、血清糖类抗原199（CA199）水平，不良反应发生情况，生活质量以及免疫功能。 结果 研究组总有效率（88.89%）高于对照组（68.89%），差异有统计学意义（P < 0.05）。两组治疗后CA724、CA199水平显著低于治疗前，差异均有高度统计学意义（均P < 0.01）。研究组血清CA724、CA199水平较对照组显著降低，差异均有高度统计学意义（均P < 0.01）。两组白细胞减少、恶心呕吐、肝肾功能异常以及脱发的发生率比较，差异均无统计学意义（均P > 0.05）。治疗后研究组卡氏功能状态评分显著高于对照组，差异有高度统计学意义（P < 0.01）。研究组CD4+、CD4+/CD8+水平较对照组显著升高，差异有统计学意义（P < 0.05或P < 0.01）。 结论 贝伐珠单抗联合紫杉醇脂质体+替吉奥治疗中晚期胃癌的临床效果显著，值得推广应用。

[关键词] 胃癌;贝伐珠单抗;紫杉醇脂质体;替吉奥;临床效果

[中图分类号] R735.2          [文献标识码] A          [文章编号] 1673-7210（2019）08（b）-0106-05

[Abstract] Objective To study the clinical effect of Bevacizumab combined with Paclitaxel Liposome and Tegafur Gimeracil and Oteracil Potassium in the treatment of medium and advanced gastric cancer. Methods Ninety patients with medium and advanced gastric cancer who were treated in the Oncology Department of Zhangjiagang First People′s Hospital from April 2012 to December 2017 were selected and divided into study group and control group according to different treatment methods， with 45 cases in each group. The control group was treated with Paclitaxel Liposome combined with Tegafur Gimeracil and Oteracil Potassium， while the study group was treated with Bevacizumab on the basis of the control group. The clinical efficacy， serum carbohydrate antigen 724 （CA724）， carbohydrate antigen 199 （CA199） levels， adverse reactions， quality of life and immune function were compared between the two groups. Results The total effective rate of the study group （88.89%） was higher than that of the control group （68.89%）， and the difference was statistically significant （P < 0.05）. The levels of CA724 and CA199 in the two groups after treatment were significantly lower than before treatment， and the differences were all highly statistically significant （all P < 0.01）. The levels of serum CA724 and CA199 in the study group were all significantly lower than those in the control group， and the differences were all highly statistically significant （all P < 0.01）. There were no significant differences in the incidence of leukopenia， nausea and vomiting， abnormal renal and liver function and alopecia between the two groups （all P > 0.05）. The Karnofsky performance score of the study group was significantly higher than that of the control group after treatment， and the difference was highly statistically significant （P < 0.01）. The levels of CD4+ and CD4+/CD8+ in the study group were significantly higher than those in the control group， and the differences were statistically significant （P < 0.05 or P < 0.01）. Conclusion Bevacizumab combined with Paclitaxel Liposome and Tegafur Gimeracil and Oteracil Potassium is effective in the treatment of medium and advanced gastric cancer. It is worth popularizing and applying.