Qin Jie, Shi Yingpeng, Zheng Xueli, Lan Ya, Zhang Mingxin, Liu Mi
Department of Gastroenterology, The First Affiliated Hospital of Xi'an Medical University, Xi'an 710077, Shaanxi, China.
Department of General Practice, The First Affiliated Hospital of Xi'an Medical University, Xi'an 710077, Shaanxi, China.
Evid Based Complement Alternat Med. 2023 Apr 6;2023:2176371. doi: 10.1155/2023/2176371. eCollection 2023.
To investigate the efficacy of fluorouracil (FU) combined with paclitaxel (PTX) and oxaliplatin (OXA) as the first-line treatment for advanced gastric signet ring cell carcinoma (SRCC) and its influence on human epidermal growth factor receptor 2 (HER-2) expression.
We collected one hundred and sixty-eight patients with advanced gastric SRCC, including 87 patients treated with FU combined with PTX and OXA as the study group (SG) and 81 patients treated with FU combined with OXA as the control group (CG). We compared indicators such as efficacy and adverse reactions after treatment between the two groups and also detected serum HER-2 expression pre- and post-treatment.
The incidence of adverse reactions differed insignificantly between SG and CG ( > 0.05). SG presented a notably higher objective response rate (ORR) and disease control rate (DCR) than that of CG ( < 0.05). After treatment, the serum HER-2 expression level of patients in both groups decreased significantly ( < 0.05), and that in SG was significantly declined compared to CG ( < 0.05). HER-2 was negatively correlated with the efficacy of both SG and CG. The 1-year survival rate in SG (29.89%) was significantly higher than that in CG (16.05%) ( < 0.05). The median OS and PFS were higher in DG than that in CG ( < 0.05).
FU combined with PTX and OXA can effectively improve the efficacy of first-line treatment for advanced gastric SRCC while reducing HER-2 expression, without increasing the adverse reaction rate. This treatment is worthy of clinical promotion.
探讨氟尿嘧啶（FU）联合紫杉醇（PTX）及奥沙利铂（OXA）作为晚期胃印戒细胞癌（SRCC）一线治疗方案的疗效及其对人表皮生长因子受体2（HER-2）表达的影响。
收集168例晚期胃SRCC患者，其中87例采用FU联合PTX及OXA治疗作为研究组（SG），81例采用FU联合OXA治疗作为对照组（CG）。比较两组治疗后的疗效、不良反应等指标，并检测治疗前后血清HER-2表达情况。
SG和CG不良反应发生率差异无统计学意义（>0.05）。SG的客观缓解率（ORR）和疾病控制率（DCR）显著高于CG（<0.05）。治疗后，两组患者血清HER-2表达水平均显著下降（<0.05），且SG下降幅度显著大于CG（<0.05）。HER-2与SG和CG的疗效均呈负相关。SG的1年生存率（29.89%）显著高于CG（16.05%）（<0.05）。SG的中位总生存期（OS）和无进展生存期（PFS）均高于CG（<0.05）。
FU联合PTX及OXA可有效提高晚期胃SRCC一线治疗的疗效，同时降低HER-2表达，且不增加不良反应发生率。该治疗方案值得临床推广。
