陈珑　王琳　何冬雷

[摘要] 目的 探讨比较小牛脾提取物注射液联合替吉奥化疗治疗中晚期胃鳞癌的疗效和安全性。 方法 选取2011年9月～2017年1月海南省第三人民医院以及海南省人民医院临床确诊的中晚期原发性胃鳞癌、KPS评分≥60分、预计生存期≥3个月的患者共31例，采用随机数字表法将患者分为试验组和对照组，试验组16例，对照组15例，试验组接受小牛脾提取物注射液联合替吉奥化疗方案，对照组单用替吉奥化疗方案，21 d为1个治疗周期，观察治疗后3个月两组患者的疗效和不良反应。 结果 试验组和对照组患者的有效率分别为50.0%和33.3%，两组疾病控制率分别为87.5%和66.7%，试验组患者的有效率和疾病控制率均高于對照组，差异有统计学意义（P < 0.05）；试验组和对照组患者中位生存期分别为10.0个月和7.0个月，差异有统计学意义（P < 0.05）；生存分析结果提示试验组的总生存率高于对照组，差异有统计学意义（P < 0.05）。两组常见的不良反应为骨髓抑制、腹泻、恶心呕吐、口腔炎过敏、肾功能损害等，两组不良反应发生率比较差异无统计学意义（P > 0.05）。 结论 小牛脾提取物注射液联合替吉奥治疗中晚期胃鳞癌患者的效果较替吉奥单药好，不良反应少，值得临床推广。

[关键词] 原发性胃鳞癌；小牛脾提取物注射液；替吉奥；化疗

[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0124-05

[Abstract] Objective To compare the efficacy and safety of calf spleen extract injection combined with S-1 in the treatment of advanced primary squamous cell carcinoma of the stomach. Methods A total of 31 advanced primary squamous cell carcinoma of the stomach patients with Karnofsky Performance Status （KPS） score≥60 scores and expected survival time≥3 months were enrolled from September 2011 to January 2017 in the Third People′s Hospital of Hainan Province and Hainan General Hospital. They were divided into the study group and the control group by random number table method， with 16 cases in the study group and 15 cases in the control group respectively. The patients in the study group received calf spleen extract injection combined with oral S-1 treatment. The control group received oral S-1 treatment. Each group was treated for three weeks. The efficacy and adverse events in the two groups were observed and compared post treatment for 3 months. Results The effective rates in the study group and the control group were 50.0% and 33.3% respectively， the disease control rates were 87.5% and 66.7% respectively， and the effective rate and disease control rate in the study group were both higher than those in the control group the differences were statistically significant（P < 0.05）. The median survival was 10.0 months in the study group and 7.0 months in the control group， the differences were statistically significant （P < 0.05）. The most common adverse events in the two groups were myelosuppression， diarrhea， nausea and vomiting， oral mucositis， allergy， renal impairment and so on， the incidence of adverse reactions in the two groups had no significant difference （P > 0.05）. Conclusion Efficacy and safety of calf spleen extract injection combined with S-1 in the treatment of advanced primary squamous cell carcinoma of the stomach are better than S-1， with less adverse reactions and it is worth clinical promotion.

[Key words] Primary squamous cell carcinoma of the stomach； Calf spleen extract injection； S-1； Chemotherapy

胃癌是发展中国家和地区最为常见的消化道恶性肿瘤之一，胃癌的绝大多数病理类型为腺癌，原发性胃鳞癌（SCC）是非常少见的胃恶性肿瘤，占胃癌总数0.04%～0.40%[1]；多发于男性患者，原发性胃鳞癌临床症状与胃其他恶性肿瘤类似，原发胃鳞癌进展期较为多见，中晚期胃鳞癌对放化疗敏感性比胃腺癌差，但近年来，有研究表明，替吉奥是新型氟尿嘧啶衍生物类化疗药物，替吉奥联合小牛脾注射液等其他综合治疗效果较好，且……