质子泵抑制剂对进展期胃癌化疗方案临床疗效的影响

中国临床药理学与治疗学 ›› 2017, Vol. 22 ›› Issue (8): 933-936.

质子泵抑制剂对进展期胃癌化疗方案临床疗效的影响

翟蒙蒙¹，李志刚²，沈杰³，王凤丽⁴，谷宁²，杨娜⁵

¹河南中医药大学第三附属医院急诊科，²肿瘤科，⁴超声科，郑州 450000，河南； ³皖南医学院弋矶山医院临床药学部，芜湖 241001，安徽；⁵中牟县中医院神经内科，中牟 451450，河南

收稿日期:2017-02-28 修回日期:2017-06-12 出版日期:2017-08-26 发布日期:2017-08-18
通讯作者: 李志刚，男，硕士，研究生导师，主任医师，研究方向中西医结合肿瘤治疗。 E-mail：909427245@qq.com
作者简介:翟蒙蒙，女，本科，主治医师，研究方向急危重症综合治疗。 E-mail：zhaimengmeng1986@163.com
基金资助:
国家自然科学基金项目（81641141）；安徽省教育厅高校自然科学研究重点项目（KJ2015A155）

Influence of proton pump inhibitors on clinical efficacy of chemotherapy for advanced gastric cancer

ZHAI Mengmeng ¹, LI Zhigang², SHEN Jie ³, WANG Fengli ⁴, GU Ning²,YANG Na ⁵

¹Department of Emergency,² Department of Oncology, ⁴Department of Ultrasound, the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Henan, Zhengzhou 450000, China; ³Department of Clinical Pharmacy, Yijishan Hospital of Wannan Medical college, Wuhu 241001, Anhui, China; ⁵Department of Neurology, Zhongmou County Hospital of Traditional Chinese Medicine, Zhongmou 451450, Henan, China

Received:2017-02-28 Revised:2017-06-12 Online:2017-08-26 Published:2017-08-18

摘要/Abstract

摘要：

目的: 进展期胃癌患者可采用奥沙利铂联合卡培他滨（XELOX方案）作为化疗方案，但部分患者因药物副作用加服质子泵抑制剂后，是否会对口服化疗药卡培他滨的疗效产生影响目前尚不确定。本研究将探讨质子泵抑制剂对进展期胃癌化疗方案临床疗效的影响。方法: 回顾性分析河南中医药大学第三附属医院2013年6月至2015年6月收治的进展期胃癌患者54例，均采用XELOX方案化疗，奥沙利铂130 mg/m2，持续静脉滴注2 h；卡培他滨1 000 mg/m2，早晚饭后半小时内服用，D1-14，21 d为一个周期；接受质子泵抑制剂治疗的患者24例为观察组，未接受质子泵抑制剂治疗30例为对照组，上述患者最多接受8个周期化疗。结果: 观察组中23例可评价疗效，平均随访10.3个月，中位疾病进展时间5.7个月（95%置信区间4.6～7.1个月），中位生存时间10.2个月（95%置信区间7.7～12.8个月）；对照组28例可评价疗效，平均随访时间11.0个月，中位疾病进展时间6.1个月（95%置信区间4.8～7.3个月），中位生存时间11.1个月（95%置信区间8.3～13.1个月）。结论: 质子泵抑制剂提高胃液pH，可能影响卡培他滨的药物溶解和吸收，进而可能会对XELOX化疗方案治疗进展期胃癌的疗效产生影响。

关键词: 胃癌, 质子泵抑制剂, 卡培他滨

Abstract:

AIM: Oxaliplatin combined with capecitabine (XELOX program) is the preferred chemotherapy regimen for patients with advanced gastric cancer. But, it remains uncertain whether extra administration of proton pump inhibitors (PPI) will influence the effect of capecitabine. This study investigates the influence of PPI on clinical efficacy of chemotherapy for advanced gastric cancer. METHODS: Fifty-four patients with advanced gastric cancer of the second affiliated hospital of Zhengzhou University from January 2014 to January 2016 were reviewed and analyzed. They were treated with XELOX regimen, i.e., oxaliplatin 130 mg/m2, continuous intravenous drip infusion for 2 h; capecitabine 1 000 mg/m2,po.,taking in the morning and evening within half an hour after a meal, D1-14. 21 d constitutes a cycle. Patients treated with proton pump inhibitor were observed as the observation group (24 cases) and without as the control group (30 cases). All patients received maximally eight cycles of chemotherapy. RESULTS:Twenty-three cases from the observation group were evaluable.The mean follow-up was 10.3 months;the median time to progression was 5.7 months (95% confidence interval,4.6-7.1 months); the median survival time was 10.2 months (95% confidence interval, 7.7-12.8 months). While twenty-eight cases from the control group 28 cases were evaluable.The median follow-up time was 11.0 months; the median time to progression was 6.1 months (95% confidence interval, 4.8-7.3 months); the median survival time was 11.1 months (95% confidence interval 8.3-13.1 months). CONCLUSION: Proton pump inhibitors increase the pH of gastric juice and affect the dissolution and absorption of capecitabine, which may further influence the therapeutic effect of XELOX on advanced gastric cancer.

Key words: gastric cancer, proton pump inhibitor, capecitabine

中图分类号:

R735

翟蒙蒙，李志刚，沈杰，王凤丽，谷宁，杨娜. 质子泵抑制剂对进展期胃癌化疗方案临床疗效的影响[J]. 中国临床药理学与治疗学, 2017, 22(8): 933-936.

ZHAI Mengmeng, LI Zhigang, SHEN Jie, WANG Fengli, GU Ning, YANG Na. Influence of proton pump inhibitors on clinical efficacy of chemotherapy for advanced gastric cancer[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(8): 933-936.

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