摘要
目的:探究小剂量分次放疗增敏化疗在转移性结直肠癌(mCRC)治疗中的疗效及安全性。方法:根据治疗方式不同将72例一线化疗失败的mCRC患者分为观察组(n=37)和对照组(n=35)。对照组采用贝伐珠单抗^(+)化疗二线治疗。随访两年,比较两组患者的临床疗效、不良反应发生情况(白细胞、血小板)、治疗前后的血清肿瘤标志物水平[癌胚抗原(CEA)、糖类抗原199(CA199)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+))和生存情况[总生存期(OS)、无进展生存期(PFS)]。结果:观察组治疗后总有效率高于对照组(20.00%vs.43.24%,P<0.05);治疗后,两组CEA、CA199水平低于治疗前,且观察组低于对照组(P<0.05);两组CD3^(+)、CD4^(+)水平上升,且观察组高于对照组(P<0.05);CD8^(+)下降,且观察组低于对照组(P<0.05);两组白细胞下降、血小板减少等不良反应发生情况比较,差异无统计学意义(P>0.05);观察组两年OS、PFS分别为62.16%、40.54%,均高于对照组的37.14%、17.14%(P<0.05)。结论:小剂量分次放疗增敏化疗联合贝伐珠单抗^(+)化疗二线治疗mCRC具有较好的临床疗效,能改善患者的血清肿瘤标志物水平,提高其免疫功能,延长患者生存期,且具有一定安全性。
Objective:To explore the efficacy and safety of low dose fractionated radiotherapy sensitization chemotherapy in the treatment of metastatic colorectal cancer(mCRC).Methods:72 mCRC patients who failed first-line chemotherapy were divided into observation group(n=37)and control group(n=35)according to different treatment methods.The control group was treated with bevacizumab^(+)second-line chemotherapy,and the observation group was treated with low-dose fractionated radiotherapy sensitization chemotherapy^(+)bevacizumab^(+)second-line chemotherapy.After two years of follow-up,the clinical efficacy,occurrence of adverse reactions[white blood cells,platelets],serum tumor marker levels before and after treatment[carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)],immune function(CD3^(+),CD4^(+),CD8^(+))and survival outcomes[overall survival(OS),progression-free survival(PFS)]were compared between two groups of patients.Results:The total effective rate of observation group was higher than that of control group(20.00%vs.43.24%,P<0.05).The CEA and CA199 levels in the two groups after treatment were lower than those before treatment,and the observation group was lower than the control group(P<0.05).After treatment,CD3^(+)and CD4^(+)levels in both groups increased,while CD8^(+)decreased,and CD3^(+)and CD4^(+)in the observation group increased faster than that in the control group,while CD8^(+)decreased faster(P<0.05).There was no significant difference in adverse reactions such as leukopenia and thrombocytopenia between the two groups(P>0.05).The 2-year OS and PFS of the observation group were 62.16%and 40.54%,respectively,which were higher than 37.14%and 17.14%of the control group(P<0.05).Conclusion:Low-dose fractionated radiotherapy sensitization chemotherapy combined with bevacizumab^(+)chemotherapy second-line treatment of mCRC has good clinical efficacy,can improve the level of serum tumor markers in patients,improve their immune function,prolong the survival time of patients,and has certain safety.
作者
熊春
黄丹
马智
XIONG Chun;HUANG Dan;MA Zhi(Department of Oncology,the First Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou 545002,Guangxi,China)
出处
《川北医学院学报》
CAS
2024年第2期194-197,共4页
Journal of North Sichuan Medical College
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研项目(Z20170100)。
关键词
转移性结直肠癌
小剂量分次放疗
增敏化疗
贝伐珠单抗
化疗
Metastatic colorectal cancer
Low-dose fractionated radiotherapy
Sensitization chemotherapy
Bevacizumab
Chemotherapy
