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