卡培他滨联合化疗治疗进展期结肠癌疗效及其对血清VEGF、TNF-α和IL-2水平的影响

Capecitabine-based combination chemotherapy for advanced colon cancer: Curative effect and influence on serum VEGF, TNFα and IL-2 levels

目的:探讨卡培他滨联合化疗治疗进展期结肠癌疗效及其对血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和白介素-2(interleukin-2,IL-2)水平的影响.方法:90例符合纳入标准的进展期结肠癌患者按治疗方案分为对照组(n=45)和观察组(n=45).对照组给予5-氟尿嘧啶+奥沙利铂治疗,观察组给予卡培他滨+奥沙利铂治疗.观察比较两组临床疗效、血清VEGF、TNF-α、IL-2水平及不良反应发生情况.结果:观察组的总有效率为75.6%,明显高于对照组53.3%的总有效率,比较差异有统计学意义(P<0.05).治疗后,两组血清V E G F、T N F-α、I L-2水平均有不同程度下降,且与对照组相比,观察组VEGF明显下降,T N F-α、I L-2水平明显升高,比较差异都有统计学意义(均P<0.05).不良反应方面,白细胞减少、腹泻、恶心、末梢神经炎及脱发等不良反应发生率组间比较差异无统计学意义(均P>0.05).结论:卡培他滨联合奥沙利铂是进展期结肠癌的一种有效治疗方案,可以提高治疗有效率,减少肿瘤血管新生,改善免疫功能,且不良反应轻,这可能与患者体内VEGF、T N F-α和I L-2水平改善有关,临床上值得进一步研究.

AIM： To investigate the clinical effect of capecitabine-based combination chemotherapy in patients with advanced colon carcinoma and its effects on serum levels of vascular endothelial growth factor （VEGF）, tumor necrosis factor-α （TNF-α） and interleukin-2 （IL-2）. METHODS： Ninety patients with advanced colon carcinoma who met the inclusion criteria were divided into two groups equally according to therapeutic scheme. The control group was treated with 5-fluorouraci and oxaliplatin, while the observation group was treated with capecitabine and oxaliplatin. The curative efficacy, serum levels of VEGF, TNF-α, and IL-2, and the rates of adverse reactions were observed and compared. RESULTS： The observation group had a therapeutic efficiency ratio （TER） of 75.6%, which was significantly higher than 53.3% in the control groups （P 〈 0.05）. After treatment, concentration of serum VEGF, TNF-α and IL-2 in the two groups were all reduced （P 〈 0.05 for all）. In comparison with the control group, concentration of VEGF was statistically lower, while concentrations of TNF-α and IL-2 were statistically higher in the observation group （P 〈 0.05 for all）. As to adverse reactions, the rates of leucopenia, diarrhea, nausea, peripheral neuritis and alopecia were comparable between the two groups （P 〉 0.05 for all）. CONCLUSION： Combined treatment with capecitabine with oxaliplatin for advanced colon carcinoma is effective, which can increase TER, reduce tumor neovascularization and improve immunological function with minor adverse reactions.