集束化用药管理干预联合免疫检查点抑制剂用于转移性结肠癌的疗效观察

Observation on Efficacy of Intervention of Clustered Medication Management Combined with Immunological Checkpoint Inhibitors in Treatment of Metastatic Colon Cancer

目的:探讨集束化用药管理干预联合免疫检查点抑制剂用于转移性结肠癌的临床效果。方法:纳入2017年8月至2018年8月首都医科大学附属友谊医院肿瘤中心68例使用纳武单抗联合FORFOX方案(奥沙利铂+亚叶酸钙+氟尿嘧啶)或FORFILI方案(伊立替康+亚叶酸钙+氟尿嘧啶)治疗的转移性结肠癌患者,采用随机分组方法分为观察组和对照组,每组34例。观察组患者采用集束化用药管理方案,对照组患者采用常规用药管理方案,比较两组患者的临床疗效、药品不良反应发生情况和护理满意度的差异。结果:观察组患者的客观缓解率为23.53%(8/34),高于对照组的14.71%(5/34),但差异无统计学意义(P>0.05);观察组患者的疾病控制率为100.00%(34/34),明显高于对照组的85.29%(29/34),差异有统计学意义(P<0.05);观察组患者的胃肠道反应、骨髓抑制及自身免疫相关不良反应的发生率均低于对照组,但差异均无统计学意义(P>0.05);观察组患者的护理满意度高于对照组,差异有统计学差异(P<0.05)。结论:集束化用药管理干预可提高晚期结肠癌患者免疫治疗联合化疗的疗效,提高患者对医疗及护理工作的满意度。

OBJECTIVE:To probe into the clinical efficacy of intervention of clustered medication management combined with immunological checkpoint inhibitors in treatment of metastatic colon cancer.METHODS:68 patients with metastatic colon cancer receiving nivolumab combined with FORFOX regimen(oxaliplatin+calcium folinate+fluorouracil)or FORFILI regimen(irinotecan+calcium folinate+fluorouracil)admitted into Beijing Friendship Hospital of Capital Medical University from Aug.2017 to Aug.2018 were selected and randomly divided into observation group and control group,with 34 cases in each group.The observation group was given clustered medication management,while the control group was given conventional medication management,differences in clinical efficacy,incidences of adverse drug reactions and nursing satisfaction between two groups were compared.RESULTS:The objective remission rate of observation group was 23.53%(8/34),which was higher than that of the control group(14.71%,5/34),with no statistically significant difference(P>0.05);the disease control rate of observation group was 100.00%(34/34),which was significantly higher than that of the control group(85.29%,29/34),with statistically significant difference(P<0.05);the incidences of gastrointestinal reaction,myelosuppression and autoimmunity-associated adverse drug reactions were lower than those of the control group,while the differences had no statistical significance(P>0.05);the nursing satisfaction of observation group was significantly higher than that of the control group,with statistically significant difference(P<0.05).CONCLUSIONS:Intervention of clustered medication management can improve the efficacy of immunological therapy combined with chemotherapy in treatment of advanced colon cancer,promote patients'satisfaction on medical and nursing word.