谷氨酰胺在晚期胃癌三维适形放疗同步XELOX方案化疗中的应用研究

Application of Glutamine in three-dimensional conformal radiotherapy combined with XELOX regimen for patients with advanced gastric cancer

摘要:

目的：观察谷氨酰胺（Glutamine，Gln）对47例同步放化疗晚期胃癌患者胃肠道反应的影响。方法：47例局部晚期无法手术的胃癌或根治术后出现肿瘤局部复发的患者随机分为治疗组和对照组（治疗组24例，对照组23例），治疗组给予三维适形放疗同步行奥沙利铂+卡培他滨（XELOX）方案化疗，同时口服Gln 3粒，tid，直至治疗结束；对照组仅给予相同方案的同步放化疗。观察2组患者的近期疗效、生活质量及不良反应。结果：治疗组和对照组治疗完成率分别为87.5%和60.9%（P=0.03）。治疗组口腔黏膜炎、恶心、呕吐、腹痛、腹泻等胃肠道副反应的发生率低于对照组（P<0.05），治疗组患者的生活质量高于对照组（P<0.05），2组的近期疗效（完全缓解、部分缓解、客观有效率）无明显差异（P>0.05）。结论：对胃癌同步放化疗患者补充Gln能够降低放化疗引起的胃肠道副反应，提高患者的治疗依从性和生活质量。

Abstract:

Objective：To evaluate the effect of Glutaimne（Gln） on gastrointestinal tract reactions in patients with advanced gastric can－cer who undergo concurrent chemoradiotherapy. Methods：Totally 47 patients with locally advanced inoperable gastric cancer or local recurrence after radical resection were randomly divided into treatment group and control group. The trentment group were treated with three-dimensional conformal radiotherapy combined with XELOX（Oxaliplatin + Capecitabine） regimen，and oral Gln（tid） at the same time until the end of treatment. The control group only received the same concurrent chemoradiotherapy. Short-term efficacy，life quality and side effects were observed during treatment. Results：Completion rates in treatment group and control group were 87.5% and 60.9%（P=0.03），respectively. Incidences of oral mucositis，nausea/vomiting，abdominal pain/diarrhea and other gastrointestinal re－actions in treatment group were lower than those in control group（P<0.05 ），while life quality was higher in treatment group than in control group（P<0.05）. There was no significant difference（P >0.05） in complete response（CR），partial response（PR） and response rate（RR） between the two groups. Conclusions：Application of Gln in concurrent chemoradiotherapy for patients with gastric cancer can reduce chemotherapy-induced gastrointestinal side effects，improve compliance and life quality of patients.