摘要
目的探讨靶向治疗联合伊立替康对老年晚期胃癌患者NF-кB、NES1和CEA表达及生活质量的影响。方法选取2016年1月至2017年2月间上海国际医学中心收治的89例老年晚期胃癌患者,采用随机数表法分为观察组45例对照组44例。观察组患者采用伊立替康+靶向治疗,对照组患者采用伊立替康治疗。比较两组患者治疗后临床疗效、生活质量、糖类抗原199(CA199)、癌胚抗原(CEA)、糖类抗原242(CA242)、核转录因子(NF-κB)和正常上皮细胞特异性-1(NES1)等血清肿瘤标志物变化及不良反应发生情况。结果观察组患者总有效率为95.6%,对照组为72.7%,差异有统计学意义(P<0.05)。治疗后,两组患者生活质量各项评分均提高,且观察组均高于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者CA199、CEA和CA242指标水平均降低,且观察组均降低更多,差异均有统计学意义(均P<0.05)。治疗后,两组患者NF-κB和NES1表达水平均提高,且观察组均高于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者均出现白细胞减少、血小板减少、血红蛋白减少、胃肠道反应和肝肾功能损害等不良反应,观察组患者发生率为13.3%,低于对照组的36.4%,差异有统计学意义(P<0.05)。结论老年晚期胃癌患者采用靶向治疗+伊立替康治疗,可提高患者生活质量,降低血清肿瘤标志物水平,减少不良反应,效果显著。
Objective To investigate the effects of targeted therapy combined with irinotecan on the expression of NF-кB,NES1,CEA and the quality of life in elderly patients with advanced gastric cancer.Methods Eighty-nine elderly patients with advanced gastric cancer treated at Shanghai International Medical Center from January 2016 to February 2017 were selected and randomly divided into an observation group（45 patients） and a control group（44 patients）. The observation group was treated with irinotecan plus targeted therapy and the control group was treated with irinotecan. The clinical efficacy of the treatment quality of life,changes in serum tumor markers including carbohydrate antigen 199（CA199）,carcinoembryonic antigen（CEA）,carbohydrate antigen 242（CA242）,nuclear transcription factor（NF-κB） and normal epithelial cell specific-1（NES1） and incidence of adverse reaction after the treatment were compared.Results The overall efficacy rate was 95. 6% for the observation group and 72. 7% for the control group（P〈0. 05）. After the treatment,quality of life scores were increased in both groups,with the increase higher in the observation group than in the control group（all P〈0. 05）. After the treatment,serum tumor marker levels of CA199,CEA,and CA242 were decreased,with the decrease higher in the observation group than in the control group（all P〈0. 05）. After the treatment,the expression level of NF-κB and NES1 was increased in both groups with the increase higher in the observation group than in the control group（all P〈0. 05）. After the treatment,leukopenia,thrombocytopenia,decreased hemoglobin,gastrointestinal reactions,liver and kidney function damage and other adverse reactions occurred in both groups and the incidence was 13. 3% in the observation group which was lower than 36. 4% of the control group（P〈0. 05）. Conclusion Targeted therapy plus irinotecan can improve quality of life,reduce the level of serum tumor markers and reduce the incidence of adverse reactions in elderly patients with advanced gastric cancer.
作者
于雷
贾麟
YU Lei;JIA Lin(Department of Oncology, Shanghai International Medical Center, Shanghai 201318, China)
出处
《中国肿瘤临床与康复》
2018年第5期529-532,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
靶向治疗
伊立替康
胃肿瘤
生活质量
Targeted therapy
Irinotecan
Gastrointestinal neoplasms
Quality of life
