摘要
目的 通过进展期胃癌患者T细胞亚群及肿瘤标志物水平变化,探究PD-1(程序性细胞死亡蛋白-1)抑制剂联合FOLFOX4化疗方案(奥沙利铂+5-氟尿嘧啶+亚叶酸)临床治疗效果.方法 收集平顶山市第一人民医院2020年3月-2022年4月收治的78例进展期胃癌患者病历,以不同治疗方案分为2组,各39例.对照组予以奥沙利铂+5-氟尿嘧啶+亚叶酸治疗,联合组在此基础上加用PD-1抑制剂治疗.对比两组疗效、肿瘤标志物[癌胚抗原(CEA)、糖类抗原50(CA50)、糖类抗原153(CA153)、糖类抗原199(CA199)]、T细胞亚群(CD4+、CD4+/CD8+、CD3+)、毒副反应.结果 联合组总有效率(ORR)(61.54％)高于对照组(38.46％)(P＜0.05);联合组中位无进展生存期(mPFS)、中位总生存期(mOS)高于对照组(P＜0.05);治疗后联合组CEA、CA50、CA153、CA199低于对照组(P＜0.05);治疗后联合组CD4+、CD4+/CD8+、CD3+高于对照组(P＜0.05);两组恶心呕吐、血小板下降、腹泻、白细胞减少、口腔黏膜炎、肝肾功能损伤、周围神经毒性发生率相比,差异无统计学意义(P＞0.05).结论 PD-1抑制剂联合FOLFOX4化疗方案治疗进展期胃癌效果确切,可控制肿瘤生长,减轻免疫抑制,提高PFS、OS,安全有效.
Abstract
Objective To investigate the clinical efficacy of PD-1(Programmed Cell Death Protein-1)inhibitor com-bined with FOLFOX4 chemotherapy regimen(oxaliplatin+5-fluorouracil+folic acid)in the treatment of advanced gastric cancer patients through changes in T cell subsets and tumor marker levels.Methods The medical records of 78 patients with advanced gastric cancer admitted to the First People's Hospital of Pingdingshan City from March 2020 to April 2022 were collected.They were divided into two groups with different treatment plans,with 39 cases in each group.The control group was treated with oxaliplatin,5-fluorouracil,and folic acid,while the combination group was treated with PD-1 inhibi-tors on this basis.Compare the efficacy,tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 50(CA50),carbohydrate antigen 153(CA153),carbohydrate antigen 199(CA199)],T cell subsets(CD4+,CD4+/CD8+,CD3+),and toxic side effects between two groups.The total effective rate(ORR)of the combined group(61.54％)was higher than that of the control group(38.46％)(P＜0.05);The median progression free survival(mPFS)and median o-verall survival(mOS)in the combination group were higher than those in the control group(P＜0.05);After treatment,the CEA,CA50,CA153,and CA199 levels in the combination group were lower than those in the control group(P＜0.05);After treatment,the CD4+,CD4+/CD8+,and CD3+levels in the combination group were higher than those in the control group(P＜0.05);There was no statistically significant difference(P＞0.05)in the incidence of nausea,vomiting,throm-bocytopenia,diarrhea,leukopenia,oral mucosal inflammation,liver and kidney function damage,and peripheral neurotoxicity between the two groups.Conclusion The combination of PD-1 inhibitor and FOLFOX4 chemotherapy regimen is effective in treating advanced gastric cancer,controlling tumor growth,reducing immune suppression,improving PFS and OS,and is safe and effective.
维普
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