多西他赛＋奥沙利铂＋替吉奥与多西他赛＋顺铂＋氟尿嘧啶方案治疗晚期胃癌的对比研究

摘要

目的：：比较多西他赛＋奥沙利铂＋替吉奥与多西他赛＋顺铂＋氟尿嘧啶方案治疗晚期胃癌的预后情况及血清指标.方法：选择在我院接受化疗的496例晚期胃癌患者，随机分为 DSOX 组(多西他赛＋奥沙利铂＋替吉奥组)和 DCF 组(多西他赛＋顺铂＋氟尿嘧啶组)，随访无进展生存时间(PFS)以及总生存时间(OS)；化疗前和化疗后2个周期时，采集血清并测定 ALT、AST、BUN、CR、CRP、CEA、CA19-9、CA72-4、VEGF、IGF-1、MMP2、MMP7、MMP9的含量.结果：DSOX 组中位 PFS 和中位 OS均长于 DCF 组；化疗后，两组血清 ALT、AST、BUN、CR、CRP 含量均高于化疗前(P ＜0．05)；且两组间的血清 ALT、AST、BUN、CR、CRP 含量无差异(P ＞0．05)；化疗后，两组血清中 CEA、CA19-9、CA72-4、VEGF、IGF-1、MMP2、MMP7、MMP9的含量均显著低于化疗前(P ＜0．05)；且 DSOX 组患者化疗后血清中 CEA、CA19-9、CA72-4、VEGF、IGF-1、MMP2、MMP7、MMP9的含量显著低于 DCF 组(P ＜0．05).结论：DSOX 化疗方案能够延长晚期胃癌患者的无进展生存时间及总生存时间且对癌细胞的杀伤效果、对胃癌组织中血管新生以及癌细胞侵袭的抑制效果优于 DCF 方案.%[ABSTRACT]Objective:To compare the prognosis and serum indexes after treatment of docetaxel in combination with ox-aliplatin + S-1 or docetaxel in combination with cisplatin + fluorouracil on advanced gastric cancer.Methods:A total of 496 patients with advanced gastric cancer who received chemotherapy in our hospital were selected and randomly divided into DSOX group (docetaxel + oxaliplatin + S-1 group)and DCF model group (docetaxel + cisplatin + fluorouracil group),and the progression-free survival (PFS)and overall survival (OS)were followed up;before chemotherapy and after two cycles of chemotherapy,serum was collected to determine ALT,AST,BUN,CR,CRP,CEA,CA1 9-9,CA72-4,VEGF,IGF-1, MMP2,MMP7 and MMP9 levels.Results:Median PFS and median OS of DSOX group were longer than those of DCF group;after chemotherapy,serum ALT,AST,BUN,CR and CRP levels of both groups were higher than those before chemotherapy (P <0.05 )but difference in serum ALT,AST,BUN,CR and CRP levels between two groups were not significant (P >0.05);after chemotherapy,serum CEA,CA1 9-9,CA72-4,VEGF,IGF-1,MMP2,MMP7 and MMP9 levels of both groups were significantly lower than those before chemotherapy (P < 0.05 )and serum CEA,CA1 9-9,CA72-4,VEGF,IGF-1, MMP2,MMP7 and MMP9 levels of DSOX group were significantly lower than those of DCF group (P <0.05 ).Conclusion:DSOX chemotherapy can prolong progression-free survival and overall survival in patients with advanced gastric cancer and has better killing effect on cancer cells and better inhibiting effect on angiogenesis in gastric cancer tissue and cancer cell invasion than DCF chemotherapy.