摘要
目的探讨晚期胃癌化疗患者在使用XELOX化疗方案与XELOX联合沙利度胺疗法中CYP2C19基因多态性与治疗效果的关系。方法选取49例晚期胃癌化疗患者为研究对象,按照化疗方案不同将患者分为XELOX组(23例)和XELOX联合沙利度胺组(26例),并根据CYP2C19基因型不同,将XELOX组患者分为单独化疗强代谢(EM)组(13例)和单独化疗弱代谢(PM)组(10例);将XELOX联合沙利度胺组患者分为药物联合化疗EM组(17例)和药物联合化疗PM组(9例)。比较不同基因型晚期胃癌化疗患者近远期疗效和不良反应情况。结果单独化疗EM组与单独化疗PM组客观缓解率(ORR)和疾病控制率(DCR)比较,差异无统计学意义(P>0.05)。药物联合化疗EM组与药物联合化疗PM组ORR和DCR比较,差异无统计学意义(P>0.05)。随访12~36个月,单独化疗EM组与单独化疗PM组中位生存期和1年生存率比较,差异无统计学意义(P>0.05)。药物联合化疗EM组与药物联合化疗PM组中位生存期和1年生存率比较,差异无统计学意义(P>0.05)。单独化疗EM组与单独化疗PM组不良反应发生率比较,差异无统计学意义(P>0.05)。药物联合化疗EM组眩晕和恶心呕吐发生率(35.29%、35.29%)显著低于药物联合化疗PM组(77.78%、77.78%),差异有统计学意义(P<0.05),其余不良反应发生率比较,差异无统计学意义(P>0.05)。结论CYP2C19基因多态性对沙利度胺抗晚期胃癌的近远期疗效无明显影响,但EM型患者能够部分耐受化疗后的不良反应,对PM型患者在化疗方案中联合服用沙利度胺可提高疗效。
Objective To discuss the correlation between CYP2C19 gene polymorphism and effect of thalidomide combined therapy in the treatment of advanced gastric cancer patients with chemotherapy.Methods 49 cases of advanced gastric cancer patients with chemotherapy were selected for the study,and the patients were divided into XELOX group(23 cases)and XELOX combined with thalidomide group(26 cases)according to different chemotherapy regimens,and the patients in XELOX group were divided into chemotherapy alone extensive metabolism(EM)group(13 cases)and chemotherapy alone poor metabolism(PM)group(10 cases)according to different CYP2C19 genotypes;the XELOX combined with thalidomide group was divided into drugcombination chemotherapy EM group(17 cases)and drug-combination chemotherapy PM group(9 cases).The short-term and long-term efficacy and adverse reactions of chemotherapy patients with different genotypes of advanced gastric cancer were compared.Results The differences in objective remission rate(ORR)and disease control rate(DCR)between the chemotherapy alone EM group and the chemotherapy alone PM group were not statistically significant(P>0.05).There was no statistically significant difference in ORR and DCR between the drug-combination chemotherapy EM group and the drug-combination chemotherapy PM group(P>0.05).At 12-36 months of follow-up,the median survival and 1-year survival rates between the chemotherapy alone EM group and chemotherapy alone PM group were not statistically significant(P>0.05).The differences in median survival and 1-year survival rates between the drug-combination chemotherapy EM group and the drug-combination chemotherapy PM group were not statistically significant(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the chemotherapy alone EM group and the chemotherapy alone PM group (P>0.05). The incidence of vertigo and nausea and vomiting in the drug-combination chemotherapy EM group were 35.29% and 35.29%, which were significantly lower than 77.78% and 77.78% in drug-combination chemotherapy PM group, and the differences were all statistically significant (P<0.05), and the difference was not statistically significant when comparing the incidence of the remaining adverse reactions (P>0.05). Conclusion CYP2C19 gene polymorphism has no significant effect on the short-term and long-term efficacy of thalidomide on advanced gastric cancer, but EM patients can partially tolerate the adverse reactions after chemotherapy, and PM patients can take thalidomide in combination with chemotherapy regimen to improve the efficacy.
作者
黄莉
叶建明
廖家华
王祥财
涂福平
郭蒸
HUANG Li;YE Jian-ming;LIAO Jia-hua(Department of Oncology,First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China)
出处
《中国现代药物应用》
2022年第22期23-26,共4页
Chinese Journal of Modern Drug Application
