摘要
目的观察贝伐珠单抗联合XELOX化疗治疗晚期结直肠癌的疗效及对患者血清炎性因子水平、免疫功能和生存时间的影响。方法选取2018年1月—2020年3月于福建省南平市人民医院/福建中医药大学附属南平人民医院接受治疗的结直肠癌患者90例,采取随机数字表法分为观察组(n=45)和对照组(n=45)。对照组患者予以XELOX化疗,观察组患者在对照组基础上予以贝伐珠单抗治疗,2组均以21 d为1个周期,持续治疗3个周期。治疗3个周期后比较2组治疗效果,治疗前后血清炎性因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、免疫功能指标[总T淋巴细胞(CD3^(+))、辅助T淋巴细胞(CD4^(+))、抑制/细胞毒T淋巴细胞(CD8^(+))],不良反应及治疗后1年、2年生存率。结果治疗3个周期后,观察组客观缓解率为53.33%,高于对照组的31.11%(χ^(2)=4.555,P=0.033);2组患者血清CRP、IL-6及TNF-α水平均较治疗前明显下降,且观察组低于对照组(P均<0.01);2组患者CD3^(+)、CD4^(+)较治疗前升高,CD8^(+)较治疗前降低,且观察组升高/降低幅度大于对照组(P均<0.01)。治疗期间2组恶心呕吐、胃肠道不适、肝肾功能损伤、骨髓抑制发生率比较差异均无统计学意义(P>0.05)。治疗后观察组1年生存率为86.67%、2年生存率为64.44%,均高于对照组的66.67%、40.00%(χ^(2)=5.031,P=0.025;χ^(2)=5.388,P=0.020)。结论贝伐珠单抗联合XELOX化疗治疗晚期结直肠癌患者效果良好,可提高疾病缓解率,有效降低患者炎性因子水平,提高免疫功能,且用药安全性高,并可延长患者生存时间。
Objective To observe the efficacy of bevacizumab combined with XELOX chemotherapy scheme in the treatment of advanced colorectal cancer and its influence on the level of serum inflammatory factors,immune function and survival time.Methods A total of 90 patients with advanced colorectal cancer from August 2019 to August 2022 in Fujian Nanping People′s Hospital/Nanping People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine were divided into observation group(n=45)and control group(n=45)by random number table method.The control group was treated with XELOX chemotherapy scheme,and the observation group was treated with bevacizumab on the basis of the control group.The therapeutic effect of two groups after 3 cycles of treatment were compared.The levels of serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and immune function indicators(CD3^(+),CD4^(+),CD8^(+))between the two groups were compared before and after treatment.The adverse reactions and 1,2-year survival rates after treatment between the two groups were compared.Results After 3 cycles of treatment,the ORR in the observation group was 53.33%,higher than 31.11%in the control group(χ^(2)=4.555,P=0.033);Serum levels of CRP,IL-6 and TNF-αin two groups were significantly lower than before treatment,and the observation group were lower than the control group(all P<0.01);CD3^(+)and CD4^(+)in two groups increased compared to before treatment,while CD8^(+)decreased compared to before treatment,and increase/decrease amplitude in the observation group were greater than those in the control group(all P<0.01).There were no statistically significant difference in the incidence of nausea,vomiting,gastrointestinal discomfort,liver and kidney function damage,and myelosuppression between the two groups during the treatment period(P>0.05).After treatment,the 1-year survival rate of the observation group was 86.67%,and the 2-year survival rate was 64.44%,both higher than the 66.67%and 40.00%o
作者
包久铭
陈瑞
BAO Jiuming;CHEN Rui(Department of Oncology,Fujian Nanping People′s Hospital/Nanping People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fujian Province,Nanping 353000,China)
出处
《临床合理用药杂志》
2023年第26期20-23,28,共5页
Chinese Journal of Clinical Rational Drug Use
