国际肿瘤学杂志

国际肿瘤学杂志 ›› 2023, Vol. 50 ›› Issue (2): 82-86.doi: 10.3760/cma.j.cn371439-20220506-00017

• 论著 • 上一篇    下一篇

复方苦参注射液联合SOX方案治疗老年晚期胃癌的临床疗效

杨俊, 李荣, 曾建昌()   

  1. 武汉市蔡甸区人民医院肿瘤科，武汉 430000
  • 收稿日期:2022-05-06 修回日期:2022-12-05 出版日期:2023-02-08 发布日期:2023-03-22
  • 通讯作者: 曾建昌，Email：zengjianchang@163.com

Clinical efficacy of Compound Kushen Injection combined with SOX regimen in the treatment of elderly patients with advanced gastric cancer

Yang Jun, Li Rong, Zeng Jianchang()   

  1. Department of Oncology，Caidian District People's Hospital of Wuhan，Wuhan 430000，China
  • Received:2022-05-06 Revised:2022-12-05 Online:2023-02-08 Published:2023-03-22
  • Contact: Zeng Jianchang，Email：zengjianchang@163.com

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摘要：

目的 探究复方苦参注射液联合SOX方案（替吉奥+奥沙利铂）治疗老年晚期胃癌患者的临床疗效及对生命质量的影响。方法 回顾性分析2017年5月至2021年12月武汉市蔡甸区人民医院收治的76例老年晚期胃癌患者，依据治疗方式的不同分为研究组（n=38）和对照组（n=38）。研究组采用复方苦参注射液联合SOX方案治疗，对照组采用SOX方案治疗，均接受至少2周期的化疗。对比两组患者疾病控制率（DCR），治疗前后血清癌胚抗原（CEA）、糖类抗原199（CA199）的变化；观察两组患者化疗不良反应发生情况，以及治疗前后生命质量相关指标改善情况。结果 研究组DCR为84.2%（32/38），对照组DCR为63.2%（24/38），两组差异有统计学意义（χ2=4.34，P=0.037）。研究组、对照组治疗后CEA水平均较治疗前下降[7.92（5.00，50.23）ng/ml比40.08（6.37，68.18）ng/ml，Z=3.53，P<0.001；40.24（20.12，53.69）ng/ml比41.32（11.50，63.90）ng/ml，Z=2.06，P=0.044]，研究组CEA下降水平较对照组更明显（Z=1.99，P=0.048）。研究组、对照组治疗后CA199水平均较治疗前下降[20.23（17.34，71.31）U/ml比70.14（12.75，96.95）U/ml，Z=2.70，P=0.007；54.25（30.54，76.75）U/ml比62.28（23.00，84.80）U/ml，Z=2.37，P=0.018]，两组CA199下降水平差异无统计学意义（Z=0.73，P=0.463）。两组患者化疗期间不良反应大多为1~2级，给予对症处理后不良反应消失；相较于对照组，研究组胃肠道反应[26.3%（10/38）比52.6%（20/38），χ2=5.50，P=0.019]、骨髓抑制[18.4%（7/38）比44.7%（17/38），χ2=6.09，P=0.014]、外周神经毒性[21.1%（8/38）比44.7%（17/38），χ2=4.83，P=0.028]不良反应发生率更低。在QOL评分[78.9%（30/38）比55.3%（21/38），χ2=4.83，P=0.028]、Karnofsky功能状态评分[71.1%（27/38）比47.4%（18/38），χ2=4.41，P=0.036]、血红蛋白[73.7%（28/38）比50.0%（19/38），χ2=4.52，P=0.034]、疼痛控制[65.8%（25/38）比24.1%（16/38），χ2=4.29，P=0.038]改善方面，研究组均优于对照组，差异具有统计学意义。结论 复方苦参注射液联合SOX方案治疗老年晚期胃癌患者，不仅可以提高DCR，还能降低血清肿瘤标志物CEA、CA199水平，其中CEA下降更明显，降低化疗的不良反应发生率，提高患者的生命质量。

关键词: 胃肿瘤, 复方苦参注射液, SOX方案, 生活质量

Abstract:

Objective To explore the clinical efficacy and influence on quality of life of Compound Kunshen Injection combined with SOX regimen （Tigio + Oxaliplatin） in the treatment of elderly patients with advanced gastric cancer. Methods A total of 76 elderly patients with advanced gastric cancer admitted to Caidian District People's Hospital of Wuhan from May 2017 to December 2021 were retrospectively analyzed. Patients were divided into study group （n=38） and control group （n=38） according to different treatment methods. The study group was treated with Compound Kunshen Injection combined with SOX regimen，and the control group was treated with SOX regimen. All patients received at least 2 cycles of chemotherapy. The disease control rate （DCR），the changes of serum carcinoembryonic antigen （CEA） and carbohydrate antigen 199 （CA199） before and after treatment of the two groups were compared. The occurrence of adverse reactions to chemotherapy and the improvement of quality of life related indicators before and after treatment were observed in the two groups. Results The DCR of the study group was 84.2% （32/38） and that of the control group was 63.2% （24/38），with a statistically significant difference （χ2=4.34，P=0.037）. After treatment，CEA levels in both study group and control group were decreased compared with those before treatment [7.92 （5.00，50.23） ng/ml vs. 40.08 （6.37，68.18） ng/ml，Z=3.53，P<0.001； 40.24 （20.12，53.69） ng/ml vs. 41.32 （11.50，63.90） ng/ml，Z=2.06，P=0.044]，and CEA level in the study group was decreased more significantly than that in the control group （Z=1.99，P=0.048）. After treatment，CA199 levels in both study group and control group were decreased compared with those before treatment [20.23 （17.34，71.31） U/ml vs. 70.14 （12.75，96.95） U/ml，Z=2.70，P=0.007； 54.25 （30.54，76.75） U/ml vs. 62.28 （23.00，84.80） U/ml，Z=2.37，P=0.018]，with no statistically significant difference in the reduction level of CA199 between the two groups （Z=0.73，P=0.463）. Most of the adverse reactions in the two groups during chemotherapy were grade 1-2，which disappeared after symptomatic treatment. Compared with the control group，the study group had lower incidence of gastrointestinal reaction [26.3% （10/38） vs. 52.6% （20/38），χ2=5.50，P=0.019]，myelosuppression [18.4% （7/38） vs. 44.7% （17/38），χ2=6.09，P=0.014] and peripheral neurotoxicity [21.1% （8/38） vs. 44.7% （17/38），χ2=4.83，P=0.028]. The improvements of QOL score [78.9% （30/38） vs. 55.3% （21/38），χ2=4.83，P=0.028]，Karnofsky performance status score [71.1% （27/38） vs. 47.4% （18/38），χ2=4.41，P=0.036]，hemoglobin [73.7% （28/38） vs. 50.0% （19/38），χ2=4.52，P=0.034] and pain control [65.8% （25/38） vs. 24.1% （16/38），χ2=4.29，P=0.038] of the study group were better than those of the control group，with statistically significant differences. Conclusion Compound Kunshen Injection combined with SOX regimen in the treatment of elderly patients with advanced gastric cancer can not only improve the DCR of patients，but also reduce the serum levels of tumor markers CEA and CA199，among which the CEA decline is more obvious，reduce the incidence of adverse reactions of chemotherapy and improve the quality of life of patients.

Key words: Stomach neoplasms, Compound Kushen Injection, SOX regimen, Quality of life