卡培他滨联合奥沙利铂治疗晚期结直肠癌的近远期疗效及对血清癌胚抗原、糖类抗原19-9表达水平的影响

The short-and long-term efficacy of capecitabine combined with oxaliplatin on advanced colorectal cancer and its effect on the expression of serum carcinoembryonic antigen and carbohydrate antigen 19-9

目的探讨卡培他滨联合奥沙利铂治疗晚期结直肠癌(CRC)的近远期疗效及对血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)表达水平的影响。方法采用随机数字表法将68例晚期CRC患者分为观察组与对照组,每组34例。对照组患者给予卡培他滨治疗,观察组患者给予卡培他滨联合奥沙利铂治疗。比较两组患者的近期疗效、不良反应、血清CEA和CA19-9水平及3年生存情况。结果观察组患者的客观有效率(ORR)和疾病控制率(DCR)分别为58.82%和82.35%,分别高于对照组的32.35%和58.82%,差异均有统计学意义(P﹤0.05)。化疗期间,两组患者腹泻、恶心呕吐、血小板减少、白细胞减少、手足综合征、口腔黏膜炎、周围神经毒性的严重程度比较,差异均无统计学意义(P﹥0.05)。治疗后,两组患者的血清CEA、CA19-9水平均低于本组治疗前,且观察组患者的血清CEA、CA19-9水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的3年总生存率高于对照组,平均生存时间长于对照组,差异均有统计学意义(P﹤0.05)。结论与单药卡培他滨治疗相比,卡培他滨联合奥沙利铂治疗晚期CRC可进一步提高近远期疗效,降低血清CEA、CA19-9水平,减少肿瘤负荷,延长总生存期。

Objective To investigate the short-and long-term efficacy of capecitabine combined with oxaliplatin on advanced colorectal cancer(CRC)and its effect on the expression of serum carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9).Method A total of 68 patients with advanced CRC were selected and divided into the observation group and control group with 34 cases in each group by a random number table.The control group was given capecitabine,and the observation group was given capecitabine combined with oxaliplatin.The short-term efficacy,adverse reaction,serum CEA and CA19-9 levels,and 3-year overall survival were compared between the two groups.Result The objective response rate(ORR)and disease control rate(DCR)of the observation group were 58.82%and 82.35%,respectively,which were higher than the 32.35%and 58.82%of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the severity of diarrhea,nausea and vomiting,thrombocytopenia,leukopenia,hand-foot syndrome,oral mucositis,and peripheral neurotoxicity between the two groups during chemotherapy(P>0.05).After treatment,the serum CEA and CA19-9 levels in the two groups were lower than that before treatment,and the serum CEA and CA19-9 levels in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).The 3-year overall survival rate of the observation group was higher than that of the control group,and the median survival time was longer than that of the control group,the differences were statistically significant(P<0.05).Conclusion Capecitabine combined with oxaliplatin in the treatment of advanced CRC can further improve the short-and long-term efficacy,reduce serum CEA and CA19-9 levels,reduce tumor burden,and prolong overall survival compared with capecitabine single-agent treatment.