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目的:观察曲妥珠单抗联合卡培他滨和顺铂治疗人表皮生长因子受体-2(HER-2)阳性晚期胃癌的疗效。方法:选择经组织病理学确诊的HER-2阳性晚期胃癌79例,根据治疗方案不同分为观察组(曲妥珠单抗联合卡培他滨和顺铂组)33例和对照组(卡培他滨联合顺铂组)46例。观察比较两组近期疗效,以及疾病无进展生存期(PFS)、中位总生存时间(mOS)和1年生存率等远期疗效相关指标。结果:(1)两组可评价疗效共74例,脱落5例,分别完成6个疗程。观察组33例中,获得完全缓解(CR)2例,部分缓解(PR)16例,稳定(SD)11例,进展(PD)4例,总有效率54.5%;对照组41例中,获得CR 1例,PR 12例,SD 17例,PD 11例,总有效率31.7%;观察组总有效率显著高于对照组(P<0.05)。(2)两组纳入远期疗效评价共41例,其中观察组19例,对照组22例。观察组PFS、mOS分别为6.7个月、11.5个月,对照组分别为5.8个月、10.3个月;两组PFS与mOS比较,均差异显著(P<0.05)。观察组1年生存率为42.4%,对照组为41.1%;两组比较,差异不显著(P>0.05)。结论:曲妥珠单抗联合卡培他滨和顺铂治疗HER-2阳性晚期胃癌,近期疗效和远期疗效均优于卡培他滨联合顺铂。
Objective: To observe the efficacy of trastuzumab combined with capecitabine and cisplatin in the treatment of human epidermal growth factor receptor-2 (HER-2) -positive advanced gastric cancer. Methods: Seventy-nine patients with histologically confirmed HER-2-positive advanced gastric cancer were divided into observation group (trastuzumab plus capecitabine and cisplatin group) and control group (capecitabine He combined with cisplatin cisplatin) 46 cases. The short-term curative effect, the progression-free survival (PFS), the median overall survival time (mOS) and the 1-year survival rate of the two groups were observed and compared. Results: (1) There were 74 evaluable curative effects in both groups and 5 cases were ablated, completing 6 courses respectively. Among the 33 cases in the observation group, 2 were complete remission (CR), 16 were partial remission (PR), 11 were stable (SD) and 4 were progressive (PD), the total effective rate was 54.5% 1 case of CR, 12 cases of PR, 17 cases of SD and 11 cases of PD, the total effective rate was 31.7%. The total effective rate in the observation group was significantly higher than that in the control group (P <0.05). (2) The long-term efficacy evaluation of both groups included 41 cases, of which 19 cases in the observation group and 22 cases in the control group. The PFS and mOS in the observation group were 6.7 months and 11.5 months, respectively, while those in the control group were 5.8 and 10.3 months respectively. There was significant difference between the two groups in PFS and mOS (P <0.05). The 1-year survival rate was 42.4% in the observation group and 41.1% in the control group. There was no significant difference between the two groups (P> 0.05). Conclusion: Trastuzumab combined with capecitabine and cisplatin is superior to capecitabine and cisplatin in the treatment of HER-2-positive advanced gastric cancer.