Abstract:

Objective　Observe To observe effect of 5-FU on improving the short-term efficacy and long-term survival of patients with advanced gastric cancer. Methods　Ninety-eight patients with advanced gastric cancer treated at Nanyang First People's Hospital from January 2020 to May 2022 were selected for the randomized controlled trial, and were divided into a conventional group (48 cases) and an experimental group (50 cases) by the random number table method. There were 25 males and 23 females in the conventional group; they were 43-77 (60.22±5.13) years old. There were 29 males and 21 females in the experimental group; they were 45-75 (60.33±5.21) years old. The conventional group took XELOX standard chemotherapy, and the experimental group first-line chemotherapy containing 5-FU. Both groups were treated for 4 weeks. The short-term efficacies, long-term survival cycles and quality of life after one-year follow up, and incidences of chemotherapy related adverse reactions were compared between the two groups.  t and χ² tests were applied. Results　The objective relieved rate and disease controlled rate in the experimental group were higher than those in the control group [76.00% (38/50) vs. 62.45% (30/48) and 82.00% (41/50) vs. 66.67% (32/48)], with statistical differences (χ²=4.309 and 6.159; both P<0.05). The median PFS and OS in the experimental group were higher than those in the control group [(9.25±2.11) months vs. (7.24±2.25)months and (10.24±2.21) months vs. (8.01±2.18) months], with statistical differences (t=3.060 and 2.306; both P<0.05). The scores of physical status, social and family status, emotion status, and functional status of Functional Assessment of Cancer Therapy-General (FACT-G) in the experimental group were higher than those in the control group [(22.41±5.13) vs. (19.33±5.16), (22.25±5.23) vs. (19.45±5.23), (19.47±5.18) vs. (16.23±5.35), and (22.36±5.24) vs. (19.31±5.17)], with statistical differences (t=2.963, 2.649, 3.046, and 2.899; all P<0.05). During the follow up, the incidence of chemotherapy related adverse reactions in the experimental group was lower than that in the conventional group [24.00% (12/50) vs. 37.50% (18/48)], with a statistical difference (χ²=4.279, P<0.05). Conclusion　Compared with the standard chemotherapy, 5-FU assisted first-line chemotherapy can improve the short-term efficacy of patients with advanced gastric cancer, and has positive significance in prolonging the patients' life cycle and improving their quality of life, and is safe.

Key words:

Advanced gastric cancer, 5-fluorouracil, First line chemotherapy, Short efficacy, Survival situation

摘要：

目的　观察5-氟尿嘧啶（5-FU）对改善晚期胃癌患者近期疗效及远期生存情况的影响。方法　选取南阳市第一人民医院2020年1月至2022年5月收治的98例晚期胃癌患者进行随机对照试验，以随机数字表法对入组患者进行分组，分别列为常规组（48例）和试验组（50例）。常规组中男25例，女23例，年龄43～77（60.22±5.13）岁，实施XELOX标准化疗；试验组中男29例，女21例，年龄45～75（60.33±5.21）岁，采用含5-FU的一线化疗，两组患者均统一治疗4个周期后评估疗效。比较两组患者的近期疗效，随访1年后的远期生存周期、生存质量及化疗相关不良反应发生情况。统计学方法采用t检验、χ²检验。结果　试验组的病灶客观缓解率（ORR）、疾病控制率（DCR）均高于常规组［76.00%（38/50）比62.45%（30/48）、82.00%（41/50）比66.67%（32/48）］，差异均有统计学意义（χ²=4.309、6.159，均P<0.05）。试验组的中位无进展生存期（PFS）、中位总生存期（OS）均高于常规组［（9.25±2.11）个月比（7.24±2.25）个月、（10.24±2.21）个月比（8.01±2.18）个月］，差异均有统计学意义（t=3.060、2.306，均P<0.05）。试验组的癌症患者生命质量测定量表（FACT-G）中生理状况、社会家庭状况、情感状况、功能状况评分均高于常规组［（22.41±5.13）分比（19.33±5.16）分、（22.25±5.23）分比（19.45±5.23）分、（19.47±5.18）分比（16.23±5.35）分、（22.36±5.24）分比（19.31±5.17）分］，差异均有统计学意义（t=2.963、2.649、3.046、2.899，均P<0.05）。随访期间，试验组的化疗相关不良反应发生率为24.00%（12/50），低于常规组［37.50%（18/48）］，差异有统计学意义（χ²=4.279，P<0.05）。结论　与标准化疗方案相比，应用5-FU+奥沙利铂化疗能改善晚期胃癌患者的近期疗效，对延长患者生存周期、改善生存质量均有积极意义，安全性更高。

关键词:

晚期胃癌, 5-氟尿嘧啶, 一线化疗, 近期疗效, 生存情况