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目的观察卡培他滨联合奥沙利铂治疗晚期食管胃交界部腺癌的临床疗效及安全性。方法将80例晚期食管胃交界部腺癌患者随机分为对照组40例和试验组40例。对照组给予静脉滴注75 mg·m~(-2)多西他赛,第1天+静脉滴注20 mg·m~(-2)顺铂,第1天+750 mg·m~(-2)氟尿嘧啶,从第1天起,持续输注120h;试验组给予静脉滴注120 mg·m~(-2)奥沙利铂,qd(用药2周后停药1周)+静脉滴注7.5 mg·kg~(-1)重组人血管内皮抑制素,qd+口服2000 mg·m~(-2)卡培他滨,bid(用药2周后停药1周)。2组患者一个周期均为21 d,共治疗3个周期。比较2组患者的临床疗效、血清肿瘤特异性大分子糖蛋白抗原19-9(CA199)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)、细胞跨膜Notch配体4(DLL4)水平以及不良反应发生率。结果治疗后,试验组的总有效率为90.00%显著高于对照组的72.50%(P<0.05)。治疗后,2组患者的CA199、CEA、VEGF、DLL4水平均显著低于治疗前(P<0.05),且试验组治疗后上述指标的水平明显低于对照组(P<0.05)。试验组的不良反应发生率为15.00%明显低于对照组的32.50%(P<0.05)。结论卡培他滨联合奥沙利铂治疗晚期食管胃交界部腺癌的临床疗效确切,且能显著降低患者血清CA199、CEA、VEGF和DLL4水平,且不良反应发生率较低。
Objective To observe the clinical efficacy and safety of capecitabine combined with oxaliplatin in the treatment of advanced esophageal-gastric adenocarcinoma. Methods Eighty patients with advanced esophageal and gastric adenocarcinoma were randomly divided into control group (40 cases) and experimental group (40 cases). The control group was given docetaxel 75 mg · m -2, on the first day + intravenous infusion of 20 mg · m -2 cisplatin, on the first day +750 mg · m ~ (- 2) Fluorouracil, continuous infusion 120h from the first day; the experimental group was given intravenous infusion of 120 mg · m -2 oxaliplatin, qd (withdrawal for 1 week after 2 weeks of treatment) + intravenous infusion 7.5 mg · kg -1 recombinant human endostatin, qd + 2000 mg · m -2 capecitabine once daily for two weeks. The two groups of patients with a cycle of 21 d, a total of three cycles of treatment. The clinical efficacy, serum tumor specific glycoprotein antigen 19-9 (CA199), carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), and cell membrane transmembrane Notch Ligand 4 (DLL4) levels were compared between the two groups. As well as the incidence of adverse reactions. Results After treatment, the total effective rate of the experimental group was 90.00%, which was significantly higher than that of the control group (72.50%, P <0.05). After treatment, the levels of CA199, CEA, VEGF and DLL4 in the two groups were significantly lower than those before treatment (P <0.05), and the levels of these indexes in the experimental group were significantly lower than those in the control group (P <0.05). The incidence of adverse reactions in the experimental group was 15.00%, which was significantly lower than that in the control group (32.50%, P <0.05). Conclusions Capecitabine combined with oxaliplatin is effective in treating advanced esophageal-gastric adenocarcinoma and can significantly reduce the serum levels of CA199, CEA, VEGF and DLL4, and the incidence of adverse reactions is low.