背景:尽管化疗对治疗晚期胃癌(aGC)有效,它可能导致不良预后。建立高效低毒的化疗方案对于改善aGC患者的疗效和预后是必要的。
目的:确定西妥昔单抗(CET)联合FOLFOX4方案(输注氟尿嘧啶,亚叶酸,和奥沙利铂)作为aGC患者的一线治疗,谁接受了循证护理(EBC)。
方法:纳入2019年3月至2022年3月接受EBC的117例aGC患者。其中,研究组(RG)60人接受了CET+FOLFOX4作为一线治疗,而对照组(CG)的57人接受了FOLFOX4。疗效[临床反应率(RR)和疾病控制率(DCR)],安全性(肝和肾功能不全,白细胞减少症,血小板减少症,皮疹,和腹泻),血清肿瘤标志物表达[STMs;糖类抗原(CA)19-9、CA72-4和癌胚抗原(CEA)],炎症指标[白细胞介素(IL)-2和IL-10],比较两组患者的生活质量。
结果:与CG相比,在RG中观察到明显更高的RR和DCR,两组之间具有同等的安全性。RG表现出显著降低的CA19-9,CA72-4,CEA,和治疗后的IL-2水平,低于治疗前水平和CG水平。治疗后IL-10在RG中统计学上增加,高于治疗前水平和CG。此外,RG的QOL明显改善。
结论:CET+FOLFOX4方案作为接受EBC的aGC患者的一线治疗非常有效。它有助于抑制STM,改善血清炎症微环境,提高生活质量,不会增加药物的不良反应。
BACKGROUND: Although chemotherapy is effective for treating advanced gastric carcinoma (aGC), it may lead to an adverse prognosis. Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.
OBJECTIVE: To determine the efficacy and safety of cetuximab (CET) combined with the FOLFOX4 regimen (infusional fluorouracil, folinic acid, and oxaliplatin) as first-line therapy for patients with aGC, who received evidence-based care (EBC).
METHODS: A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled. Of these, 60 in the research group (RG) received CET + FOLFOX4 as first-line therapy, whereas 57 in the control group (CG) received FOLFOX4. The efficacy [clinical response rate (RR) and disease control rate (DCR)], safety (liver and kidney dysfunction, leukopenia, thrombocytopenia, rash, and diarrhea), serum tumor marker expression [STMs; carbohydrate antigen (CA) 19-9, CA72-4, and carcinoembryonic antigen (CEA)], inflammatory indicators [interleukin (IL)-2 and IL-10], and quality of life (QOL) of the two groups were compared.
RESULTS: A markedly higher RR and DCR were observed in the RG compared with the CG, with an equivalent safety profile between the two groups. RG exhibited notably reduced CA19-9, CA72-4, CEA, and IL-2 levels following treatment, which were lower than the pre-treatment levels and those in the CG. Post-treatment IL-10 was statistically increased in RG, higher than the pre-treatment level and the CG. Moreover, a significantly improved QOL was evident in the RG.
CONCLUSIONS: The CET + FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC. It facilitates the suppression of STMs, ameliorates the serum inflammatory microenvironment, and enhances QOL, without increased adverse drug effects.