XELOX化疗方案联合贝伐单抗靶向对结肠癌患者免疫功能、治疗效果及生存质量的影响探究
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摘要
背景结肠癌为临床常见的恶性肿瘤之一,对其的治疗以手术和化疗为主.约有50%以上的Ⅲ期结肠癌患者,在根治术后任然出现转移、复发,因此结肠癌患者的术后远期生存率一直较低.有研究表明XELOX方案作为结肠癌治疗一线、二线药物,临床疗效不及静脉滴注5-FU/FA;但在联合贝伐单抗作为一线治疗药物,可提高转移性结肠癌化疗患者的无进展生存期.本研究观察了XELOX化疗方案联合贝伐单抗靶向对结肠癌患者免疫功能及治疗效果、生存质量的影响,为临床寻求高效低毒的结肠癌治疗方式,提高结肠癌病人的生存率及生活质量,提供更多的临床数据.目的研究XELOX化疗方案联合贝伐单抗靶向对结肠癌患者免疫功能及治疗效果、生存质量的影响.方法本次研究对象共60例,选取于中国人民解放军第903医院肿瘤科2015-05/2017-05收治的结肠癌术后化疗患者,所选研究对象按入组顺序经数字随机表法分为两组.对照组应用XELOX方案,观察在此基础上联合贝伐单抗治疗.对两组患者化疗后的临床疗效、生存质量评分及毒副反应进行评定比较,并检测治疗前后患者外周血T淋巴细胞亚群[CD~(3+)、CD~(4+)、CD~(8+)、自然杀伤细胞(natural killer cell, NK)]细胞水平情况.结果两组经治疗后观察组总有效率90.00%明显大于对照组总有效率76.67%,观察组临床疗效明显优于对照组(P<0.05),观察组治疗后CD~(3+)、CD~(4+)、CD~(8+)、NK水平显著高于对照组;观察组T淋巴细胞亚群水平显著优于对照组(P<0.05),观察组治疗后躯体、情感、社交、认知、角色功能评分显著高于对照组,观察组生存治疗显著优于对照组(P<0.05),观察组化疗后不良反应总发生率13.33%明显低于对照组为50.00%,两组比较,差异有统计学意义(P<0.05).结论 XELOX化疗方案联合贝伐单抗靶向对结肠癌患者具有良好的疗效,能有效抑制结肠癌细胞的增值,能显著改善患者免疫系统功能,并减少化疗的毒副作用,提高患者生存质量.
BACKGROUND Colon cancer is one of the most common malignant tumors in clinical practice. Surgery and chemotherapy are the main treatments. About 50% of patients with stage Ⅲ colon cancer still have metastasis and recurrence after radical operation, so the long-term survival rate of patients with colon cancer has been low. Studies have shown that XELOX regimen as a first-or secondline treatment for colon cancer has less clinical efficacy than intravenous drip of 5-FU/FA, but XELOX regimen combined with bevacizumab as a first-line treatment can improve the progression-free survival of patients with metastatic colon cancer undergoing chemotherapy.AIM To study the effect of XELOX chemotherapy combined with bevacizumab on immune function, therapeutic effect, and quality of life in patients with colon cancer. METHODS Sixty patients undergoing postoperative chemotherapy for colon cancer at our hospital were selected from May 2015 to May 2017. The subjects were divided into either a control group or a study group according to the order of grouping. The patients in the control group were treated with XELOX regimen alone, and the patients in the study group were treated with XELOX regimen plus bevacizumab. The clinical efficacy, quality of life score, and toxicity of the two groups were evaluated and compared. The levels of T lymphocyte subsets(CD~(3+), CD~(4+), CD~(8+), and NK) in peripheral blood were detected before and after treatment. RESULTS After treatment, the total effective rate of the observation group was 90.00%, which was significantly higher than that of the control group(76.67%). The clinical effect of the observation group was significantly better than that of the control group(P < 0.05). The levels of CD~(3+), CD~(4+), CD~(8+), NK in the observation group were significantly higher than those in the control group after treatment. The scores of somatic, emotional, social, and cognitive abilities and role function in the observation group were significantly higher than those in the control group(P < 0.05). The total incidence of adverse reactions in the observation group was 13.33%, which was significantly lower than that in the control group(50.00%; P < 0.05). CONCLUSION XELOX chemotherapy combined with bevacizumab has a good effect in colon cancer patients, and can effectively inhibit the proliferation of colon cancer cells, significantly improve the immune system function, reduce the side effects of chemotherapy, and improve the quality of life of patients.
BACKGROUND Colon cancer is one of the most common malignant tumors in clinical practice. Surgery and chemotherapy are the main treatments. About 50% of patients with stage Ⅲ colon cancer still have metastasis and recurrence after radical operation, so the long-term survival rate of patients with colon cancer has been low. Studies have shown that XELOX regimen as a first-or secondline treatment for colon cancer has less clinical efficacy than intravenous drip of 5-FU/FA, but XELOX regimen combined with bevacizumab as a first-line treatment can improve the progression-free survival of patients with metastatic colon cancer undergoing chemotherapy.AIM To study the effect of XELOX chemotherapy combined with bevacizumab on immune function, therapeutic effect, and quality of life in patients with colon cancer. METHODS Sixty patients undergoing postoperative chemotherapy for colon cancer at our hospital were selected from May 2015 to May 2017. The subjects were divided into either a control group or a study group according to the order of grouping. The patients in the control group were treated with XELOX regimen alone, and the patients in the study group were treated with XELOX regimen plus bevacizumab. The clinical efficacy, quality of life score, and toxicity of the two groups were evaluated and compared. The levels of T lymphocyte subsets(CD~(3+), CD~(4+), CD~(8+), and NK) in peripheral blood were detected before and after treatment. RESULTS After treatment, the total effective rate of the observation group was 90.00%, which was significantly higher than that of the control group(76.67%). The clinical effect of the observation group was significantly better than that of the control group(P < 0.05). The levels of CD~(3+), CD~(4+), CD~(8+), NK in the observation group were significantly higher than those in the control group after treatment. The scores of somatic, emotional, social, and cognitive abilities and role function in the observation group were significantly higher than those in the control group(P < 0.05). The total incidence of adverse reactions in the observation group was 13.33%, which was significantly lower than that in the control group(50.00%; P < 0.05). CONCLUSION XELOX chemotherapy combined with bevacizumab has a good effect in colon cancer patients, and can effectively inhibit the proliferation of colon cancer cells, significantly improve the immune system function, reduce the side effects of chemotherapy, and improve the quality of life of patients.
引文
1刘倩.斑蝥酸钠维生素B6注射液联合XELOX方案治疗晚期结肠癌的临床效果.中国药物经济学2018;13:66-68[DOI:10.12010/j.issn.1673-5846.2018.12.019]
2毛英,刘黎,张匠,骆雯,董华琼.辅助化疗XELOX方案与FOLFOX方案在Ⅱ~Ⅲ期结肠癌中的应用比较.实用医院临床杂志2018;15:48-52
3雷雨,于娇,何莉,段宝军,白俊.沙利度胺联合XELOX方案治疗转移性结肠癌的预后效果及影响因素.解放军医药杂志2018;30:23-26[DOI:10.3969/j.issn.2095-140X.2018.10.006]
4杨崧,梁志锋,余国湛.XELOX及mFOLFOX6化疗方案对结肠癌术后患者毒副反应的影响.中国实用医药2018;13:105-107[DOI:10.14163/j.cnki.11-5547/r.2018.18.060]
5石磊,孙新增,李宝山,白建平.Ⅱ、Ⅲ期结肠癌患者辅助化疗XELOX方案、FOLFOX方案的临床疗效、不良反应及生活质量对比.医学信息2018;31:68-72[DOI:10.3969/j.issn.1006-1959.2018.13.020]
6余峰彬,王光华.西妥昔单抗联合Xelox方案对结肠癌术后肝转移的影响及机制.山东医药2018;58:82-84[DOI:10.3969/j.issn.1002-266X.2018.20.028]
7李响,刘一丹,王若雨,赵彤,吴忠,刘莹.奥沙利铂联合替吉奥方案与XELOX方案在晚期结直肠癌治疗中的副作用对比.中国现代药物应用2018;12:87-88[DOI:10.14164/j.cnki.cn11-5581/r.2018.13.048]
8刘金鹏,江静,魏辉,贾奇,罗璐.华蟾素联合XELOX方案治疗晚期结肠癌的临床疗效观察.西部医学2017;29:1560-1563[DOI:10.3969/j.issn.1672-3511.2017.11.018]
9刘冬梅.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.医药前沿2017;7:227-228[DOI:10.3969/j.issn.2095-1752.2017.31.198]
10孙颖川.术后应用XELOX方案与FOLFOX4方案治疗结肠癌的安全性及远期疗效比较.齐齐哈尔医学院学报2017;38:2408-2409
11黄通.mFOLFOX6方案和XELOX方案辅助化疗对结肠癌根治术后患者生活质量的影响.饮食保健2017;4:38-39[DOI:10.3969/j.issn.2095-8439.2017.18.042]
12王景艳,胡妮,吴永文,乐亮.XELOX方案与FOLFOX方案治疗晚期结肠癌的药物经济学对比研究.中国当代医药2017;24:72-74
13张世尚.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.心理医生2017;23:94-95
14郭志峰.mFOLFOX6方案和XELOX方案辅助化疗对结肠癌根治术后患者生活质量的影响.中国继续医学教育2017;9:168-169[DOI:10.3969/j.issn.1674-9308.2017.22.089]
15封燕燕.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.中西医结合心血管病电子杂志2017;5:186-187[DOI:10.3969/j.issn.2095-6681.2017.20.140]
16黄涛金.mFOLFOX6方案和XELOX方案辅助化疗对结肠癌根治术后患者生活质量的影响.大家健康(上旬版)2017;11:12
17姜丹凤,朱孟秀,李江秋,高晓冬.养正消积胶囊联合XELOX方案治疗晚期结肠的癌临床研究.航空航天医学杂志2017;28:1157-1160[DOI:10.3969/j.issn.2095-1434.2017.10.002]
18王亚丽.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.临床医药文献电子杂志2017;4:6200
19孙晨.贝伐珠单抗联合化疗在转移性结肠癌治疗中的疗效及安全性研究.海峡药学2018;30:188-189
20李晓旭,荣斌,张金迪,郭尚敬.贝伐珠单抗联合化疗在结直肠癌中的研究概况.中西医结合心血管病电子杂志2018;6:31-32;35
21贾建宾,聂双发,李磊,费建东.贝伐珠单抗联合FOLFOX-6化疗方案对晚期结肠癌患者细胞凋亡及相关蛋白表达的影响.中国医药2018;13:1518-1521[DOI:10.3760/j.issn.1673-4777.2018.10.020]
22罗文杰,刘明华,罗小莉,宋博.贝伐珠单抗注射液治疗晚期结肠癌的临床研究.中国临床药理学杂志2018;34:1407-1409;1419[DOI:10.13699/j.cnki.1001-6821.2018.12.005]
2毛英,刘黎,张匠,骆雯,董华琼.辅助化疗XELOX方案与FOLFOX方案在Ⅱ~Ⅲ期结肠癌中的应用比较.实用医院临床杂志2018;15:48-52
3雷雨,于娇,何莉,段宝军,白俊.沙利度胺联合XELOX方案治疗转移性结肠癌的预后效果及影响因素.解放军医药杂志2018;30:23-26[DOI:10.3969/j.issn.2095-140X.2018.10.006]
4杨崧,梁志锋,余国湛.XELOX及mFOLFOX6化疗方案对结肠癌术后患者毒副反应的影响.中国实用医药2018;13:105-107[DOI:10.14163/j.cnki.11-5547/r.2018.18.060]
5石磊,孙新增,李宝山,白建平.Ⅱ、Ⅲ期结肠癌患者辅助化疗XELOX方案、FOLFOX方案的临床疗效、不良反应及生活质量对比.医学信息2018;31:68-72[DOI:10.3969/j.issn.1006-1959.2018.13.020]
6余峰彬,王光华.西妥昔单抗联合Xelox方案对结肠癌术后肝转移的影响及机制.山东医药2018;58:82-84[DOI:10.3969/j.issn.1002-266X.2018.20.028]
7李响,刘一丹,王若雨,赵彤,吴忠,刘莹.奥沙利铂联合替吉奥方案与XELOX方案在晚期结直肠癌治疗中的副作用对比.中国现代药物应用2018;12:87-88[DOI:10.14164/j.cnki.cn11-5581/r.2018.13.048]
8刘金鹏,江静,魏辉,贾奇,罗璐.华蟾素联合XELOX方案治疗晚期结肠癌的临床疗效观察.西部医学2017;29:1560-1563[DOI:10.3969/j.issn.1672-3511.2017.11.018]
9刘冬梅.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.医药前沿2017;7:227-228[DOI:10.3969/j.issn.2095-1752.2017.31.198]
10孙颖川.术后应用XELOX方案与FOLFOX4方案治疗结肠癌的安全性及远期疗效比较.齐齐哈尔医学院学报2017;38:2408-2409
11黄通.mFOLFOX6方案和XELOX方案辅助化疗对结肠癌根治术后患者生活质量的影响.饮食保健2017;4:38-39[DOI:10.3969/j.issn.2095-8439.2017.18.042]
12王景艳,胡妮,吴永文,乐亮.XELOX方案与FOLFOX方案治疗晚期结肠癌的药物经济学对比研究.中国当代医药2017;24:72-74
13张世尚.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.心理医生2017;23:94-95
14郭志峰.mFOLFOX6方案和XELOX方案辅助化疗对结肠癌根治术后患者生活质量的影响.中国继续医学教育2017;9:168-169[DOI:10.3969/j.issn.1674-9308.2017.22.089]
15封燕燕.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.中西医结合心血管病电子杂志2017;5:186-187[DOI:10.3969/j.issn.2095-6681.2017.20.140]
16黄涛金.mFOLFOX6方案和XELOX方案辅助化疗对结肠癌根治术后患者生活质量的影响.大家健康(上旬版)2017;11:12
17姜丹凤,朱孟秀,李江秋,高晓冬.养正消积胶囊联合XELOX方案治疗晚期结肠的癌临床研究.航空航天医学杂志2017;28:1157-1160[DOI:10.3969/j.issn.2095-1434.2017.10.002]
18王亚丽.XELOX和OLF化疗方案治疗老年晚期结肠癌的疗效及安全性.临床医药文献电子杂志2017;4:6200
19孙晨.贝伐珠单抗联合化疗在转移性结肠癌治疗中的疗效及安全性研究.海峡药学2018;30:188-189
20李晓旭,荣斌,张金迪,郭尚敬.贝伐珠单抗联合化疗在结直肠癌中的研究概况.中西医结合心血管病电子杂志2018;6:31-32;35
21贾建宾,聂双发,李磊,费建东.贝伐珠单抗联合FOLFOX-6化疗方案对晚期结肠癌患者细胞凋亡及相关蛋白表达的影响.中国医药2018;13:1518-1521[DOI:10.3760/j.issn.1673-4777.2018.10.020]
22罗文杰,刘明华,罗小莉,宋博.贝伐珠单抗注射液治疗晚期结肠癌的临床研究.中国临床药理学杂志2018;34:1407-1409;1419[DOI:10.13699/j.cnki.1001-6821.2018.12.005]