摘要
目的观察注射用卡瑞利珠单抗联合盐酸安罗替尼胶囊和FOLFOX方案(奥沙利铂、亚叶酸钙和氟尿嘧啶)治疗晚期肝癌的临床疗效。方法选取2018年1月—2019年12月海南医学院第二附属医院、海南医学院第一附属医院收治的126例晚期肝癌患者作为研究对象,根据治疗方式不同分为对照组和治疗组,每组各63例。两组均给予FOLFOX方案:第1天静脉滴注注射用奥沙利铂,85 mg/m^(2)加5%葡萄糖注射液250 mL,静脉滴注2 h;第1、2天静脉滴注注射用亚叶酸钙,200 mg/m^(2)加5%葡萄糖注射液250 mL,静脉滴注2 h;第1、2天静脉推注氟尿嘧啶注射液,400 mg/m^(2),同时持续静滴600 mg/m^(2),滴注时间22 h;治疗14 d后暂停1周。对照组在FOLFOX方案基础上早餐前口服盐酸安罗替尼胶囊,12 mg/次,1次/d,连续服药2周,停药1周。治疗组在对照组治疗的基础上静脉注射注射用卡瑞利珠单抗,3 mg/kg,间隔≥30 min后进行FOLFOX方案,1次/3周。以21 d为1个周期,两组患者至少完成2个周期。观察两组的临床疗效,比较两组的血清生化指标、肿瘤标志物水平。结果治疗后,治疗组的疾病控制率(DCR)明显高于对照组(P<0.05),但两组的总有效率(ORR)差异无统计学意义。治疗后,两组血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、凝血酶原时间(PT)水平均显著降低,白蛋白(ALB)水平显著升高(P<0.05);且治疗组血清ALT、AST、TBIL、PT水平显著低于对照组,ALB水平显著高于对照组(P<0.05)。治疗后,两组患者的血清α-L-岩藻糖苷酶(AFU)、甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)水平均明显降低(P<0.05);治疗组血清AFU、AFP、CEA、CA199水平均低于对照组(P<0.05)。结论注射用卡瑞利珠单抗联合盐酸安罗替尼胶囊和FOLFOX方案治疗晚期肝癌患者疗效确切,可提高疾病控制率,改善生化指标和血清肿瘤标志物水平,且安全性良好。
Objective To observe the clinical effect of Camrelizumab for injection combined with Anlotinib Hydrochloride Capsules and FOLFOX regimen in treatment of advanced liver cancer.Methods Patients(126 cases)with advanced liver cancer in the Second Affiliated Hospital of Hainan Medical University and the First Affiliated Hospital of Hainan Medical University from January 2018 to December 2015 were randomly divided into control and treatment groups,and each group had 63 cases.Patients in two groups were given FOLFOX regimen:On the first day,oxaliplatin for injection,85 mg/m^(2)added into 5%glucose injection 250 mL,was injected intravenously for 2 h.On the first and second day,Calcium Folinate for injection was injected intravenously for 2 h,200 mg/m^(2)added into 5%glucose injection 250 mL.On the first and second day,Fluorouracil Injection was injected intravenously 400 mg/m^(2),while continuous intravenous drip of 600 mg/m^(2)for 22 h.After 14 d of treatment,it was suspended for 1 week.Patients in the control group were po administered with Anlotinib Hydrochloride Capsules before breakfast on the basis of FOLFOX regimen,12 mg/time,once daily.The drug was taken continuously for 2 weeks,and stopped for 1 week.Patients in the treatment group were iv administered with Camrelizumab for injection on the basis of the control group,3 mg/kg,and FOLFOX scheme shall be carried out after an interval of≥30 min,once every 3 weeks.A cycle had 21 d,and patients in two groups were treated for 2 cycles.After treatment,the clinical efficacies were evaluated,and the serum levels of biochemical indexes and serological tumor markers in two groups were compared.Results After treatment,the DCR in the treatment group was significantly higher than that in the control group(P<0.05),but there was no significant difference in the ORR between two groups.After treatment,the serum levels of ALT,AST,TBIL,and PT were significantly decreased,but the level of ALB were significantly increased(P<0.05).The serum levels of ALT,AST,TBIL,and PT in the treatm
作者
王学国
杨彦
李鹏
黎东明
陆路
赵红岩
王太成
WANG Xue-guo;YANG Yan;LI Peng;LI Dong-ming;LU Lu;ZHAO Hong-yan;WANG Tai-cheng(Department of Hepatobiliary Pancreatic Surgery,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China;Department of Hepatobiliary Pancreatic Surgery,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)
出处
《现代药物与临床》
CAS
2022年第7期1554-1559,共6页
Drugs & Clinic
基金
海南省自然科学基金面上项目(821MS0833)。
