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目的探讨重组人血管内皮抑素联合替吉奥对老年晚期胃癌的临床疗效及安全性。方法回顾性分析2012年1月—2014年6月收治的进展期胃癌患者44例。分为观察组26例,对照组18例。对照组采用单药替吉奥,40 mg/m2,2次/d,餐后30 min口服,连续服用14 d;观察组在对照组基础上加用重组人血管内皮抑制素注射液15 mg加500 ml生理盐水缓慢静脉滴注,化疗前1 d起连续应用14 d,比较两组临床疗效、无进展生存期以及不良反应发生情况。计量资料采用t检验,计数资料采用χ2检验,,P<0.05为差异有统计学意义。结果观察组和对照组的客观有效率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)对比差异均无统计学意义(均P>0.05);两组患者中位无进展生存时间(progress free survival,PFS)分别为(4.1±0.1)个月和(3.1±0.2)个月,对比差异有统计学意义(P<0.05)。两组患者均为Ⅰ~Ⅱ度不良反应,其中以胃肠道反应和骨髓抑制发生率较高,各不良反应发生率对比差异均无统计学意义(均P>0.05)。结论重组人血管内皮抑素联合替吉奥治疗老年晚期胃癌疗效确切,安全性良好,值得进一步研究。
Objective To investigate the clinical efficacy and safety of recombinant human endostatin combined with tegafur in elderly patients with advanced gastric cancer. Methods We retrospectively analyzed 44 patients with advanced gastric cancer who were admitted from January 2012 to June 2014. Divided into observation group 26 cases, control group 18 cases. The control group was treated with monotherapy, 40 mg/m2, twice a day, orally for 30 minutes after a meal, and continuously for 14 days. In the observation group, a recombinant human endostatin injection plus 15 mg was added to the control group. 500 ml normal saline was intravenously instilled for 14 days from the 1st day before chemotherapy. Clinical efficacy, progression-free survival and adverse reactions were compared between the two groups. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results There was no significant difference in objective response rate (ORR) and disease control rate (DCR) between the observation group and the control group (all P>0.05); median progression-free survival was observed in both groups. The time of progression free survival (PFS) was (4.1±0.1) months and (3.1±0.2) months respectively, and the difference was statistically significant (P<0.05). Both groups had adverse reactions of grade I to II, among which the incidence of gastrointestinal reactions and myelosuppression was high, and there was no significant difference in the incidence of adverse reactions (all P>0.05). Conclusion Recombinant human endostatin combined with tegafur is effective and safe for elderly patients with advanced gastric cancer. It deserves further study.