Page 104 - 《中国药房》2022年13期

·药物与临床·

白蛋白结合型紫杉醇联合奥沙利铂一线治疗晚期胃癌的临床观察 Δ

朱万里 ，王 鹏 ，王 晖 ，王红丽 ，程 鹏 ，苟 菲（1.南阳医学高等专科学校第一附属医院普外科，河南
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南阳 473000；2.南阳医学高等专科学校第一附属医院肿瘤内科，河南 南阳 473000）
中图分类号 R979.1；R969.4 文献标志码 A 文章编号 1001-0408（2022）13-1630-05
DOI 10.6039/j.issn.1001-0408.2022.13.16
摘 要 目的 观察白蛋白结合型紫杉醇联合奥沙利铂一线治疗晚期胃癌的临床疗效和安全性。方法 将90例晚期不可手术切除
的胃癌患者按照随机数字表法分为观察组和对照组，各45例。对照组患者采用奥沙利铂联合替吉奥治疗，观察组患者采用白蛋
白结合型紫杉醇联合奥沙利铂治疗。21 d为1个化疗周期，2组患者均进行6个周期的化疗，随后每2周进行1次随访观察。比较
2组患者的近期（化疗2个周期后）疗效、中期（化疗6个周期后）疗效、肿瘤标志物表达水平、远期（随访结束后）疗效、生活质量和
不良反应发生情况。结果 化疗2个周期后，观察组患者的客观缓解率（ORR）显著高于对照组（60.00％ vs. 37.78％，P＜0.05），2组
患者疾病控制率的差异无统计学意义（P＞0.05）。化疗6个周期后，观察组患者的ORR显著高于对照组（55.56％ vs. 31.11％，P＜
0.05），2 组患者疾病控制率的差异无统计学意义（P＞0.05）；观察组患者的肿瘤标志物[癌胚抗原、糖类抗原（CA）724、CA199、
CA242]表达水平均显著低于对照组（P＜0.05）。随访结束后，观察组患者的中位无进展生存时间[8.78（95％CI为6.94～11.01）个
月]和中位总生存时间[13.02（95％CI 为 12.78～15.62）个月]均显著长于对照组[分别为 6.99（95％CI 为 3.67～10.88）个月和 10.42
（95％CI为8.72～13.22）个月]（P＜0.05）。观察组患者化疗后的躯体维度评分显著高于对照组（P＜0.05）。除周围神经毒性外，2
组患者的不良反应发生率差异无统计学意义（P＞0.05）。结论 白蛋白结合型紫杉醇联合奥沙利铂一线治疗晚期不可手术切除胃
癌具有良好的疗效和安全性。
关键词 白蛋白结合型紫杉醇；奥沙利铂；晚期胃癌；化疗；临床疗效；安全性

Clinical observation of albumin-bound paclitaxel combined with oxaliplatin in the first-line treatment of
advanced gastric cancer
ZHU Wanli ，WANG Peng ，WANG Hui ，WANG Hongli ，CHENG Peng ，GOU Fei （1. Dept. of General
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Surgery，the First Affiliated Hospital of Nanyang Medical College，Henan Nanyang 473000，China；2. Dept. of
Oncology，the First Affiliated Hospital of Nanyang Medical College，Henan Nanyang 473000，China）
ABSTRACT OBJECTIVE To observe the therapeutic efficacy and safety of albumin-bound paclitaxel combined with oxaliplatin
in the first-line treatment of advanced gastric cancer（GC）. METHODS A total of 90 advanced unresectable GC patients were
randomized into observation group and control group，with 45 patients in each group. Control group was given oxaliplatin
combined with tegafur，and observation group was given albumin-bound paclitaxel combined with oxaliplatin. A chemotherapy
cycle last for 21 days，and both groups received 6 cycles of chemotherapy，and then the follow-up observation was conducted
every 2 weeks. Short-term efficacy （after 2 chemotherapy cycles），mid-term efficacy （after 6 chemotherapy cycles），tumor
marker，long-term efficacy （after follow-up），quality of life，the occurrence of ADRs were compared between 2 groups.
RESULTS After 2 cycles of treatment，objective remission rate（ORR）of observation group was significantly higher than that of
control group（60.00％ vs. 37.78％，P＜0.05）；there was no statistical significance in disease control rate between the two groups
（P＞0.05）. After 6 chemotherapy cycles，ORR of observation group was significantly higher than that of control group（55.56％
vs. 31.11％，P＜0.05）；there was no statistical significance in disease control rate between the two groups（P＞0.05）；the levels of
tumor markers [carcinoembryonic antigen， carbohydrate antigen （CA）724， CA199， CA242] in observation group were
significantly lower than those of control group（P＜0.05）. After the follow-up period，the median progression-free survival [8.78
（95％CI：6.94-11.01）months] and the median overall survival [13.02（95％CI：12.78-15.62）months] of observation group were
significantly longer than those [6.99（95％CI：3.67-10.88）months and 10.42（95％CI：8.72-13.22）months] of control group（P＜
0.05）. The score of body dimension in the observation group was significantly higher than that in the control group（P＜0.05）.
Except for peripheral neurotoxicity，there was no significant difference in the incidence of ADR between 2 groups （P＞0.05）.
CONCLUSIONS Albumin-bound paclitaxel combined with oxaliplatin has a good effect and safety in the first-line treatment of
advanced unresectable GC.
Δ 基金项目 河南省科技发展计划项目（No.202102310079） KEYWORDS albumin-bound paclitaxel； oxaliplatin；
＊第一作者 主治医师。研究方向：普通外科。电话：0377- advanced gastric cancer； chemotherapy； clinical efficacy；
63328372。E-mail：skyzhuwanli@126.com safety

·1630 · China Pharmacy 2022 Vol. 33 No. 13 中国药房 2022年第33卷第13期