西妥昔单抗联合FOLFOXIRI方案治疗不可切除结直肠癌肝转移的临床效果

Clinical effect of Cetuximab combined with FOLFOXIRI regimen in the treatment of liver metastasis of unresectable colorectal cancer

目的探讨西妥昔单抗联合FOLFOXIRI方案治疗不可切除结直肠癌肝转移的临床效果。方法选择2013年1月~2016年5月广州中医药大学第二附属医院收治的不可切除结直肠癌肝转移患者105例,按照随机数字表法将其分为对照组(52例)和观察组(53例)。对照组给予FOLFOXIRI方案治疗,观察组给予西妥昔单抗联合FOLFOXIRI方案治疗,14 d为1个化疗周期,两组均连续治疗4个化疗周期。治疗后进行临床疗效评价。比较两组患者治疗前后的病灶数目、病灶大小及外周血CD4+、CD8+水平、CD4+/CD8+和血清糖抗原19-9(CA19-9)、癌胚抗原(CEA)水平。计算并比较两组患者治疗后6个月、1年及3年的生存率。结果观察组有效率明显高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的病灶数目和病灶大小均明显小于治疗前,且观察组明显小于对照组,差异均有统计学意义(均P<0.05)。治疗后两组患者外周血CD4+、CD8+水平及CD4+/CD8+均明显高于治疗前,且观察组明显高于对照组,差异均有统计学意义(均P<0.05)。治疗后两组患者血清CA19-9和CEA水平均明显低于治疗前,且观察组明显低于对照组,差异均有统计学意义(均P<0.05)。两组患者治疗后6个月的生存率比较,差异无统计学意义(P>0.05);观察组治疗后1年和3年的生存率均明显高于对照组,差异均有统计学意义(均P<0.05)。结论西妥昔单抗联合FOLFOXIRI方案治疗不可切除结直肠癌肝转移的临床效果显著,能够改善机体免疫功能,降低血清CA19-9和CEA水平,延长患者生存时间。

Objective To investigate the clinical effect of Cetuximab combined with FOLFOXIRI regimen in the treatment of liver metastasis of unresectable colorectal cancer.Methods From January 2013 to May 2016,105 patients with liver metastasis of unresectable colorectal cancer admitted to the Second Affiliated Hospital of Guangzhou University of Chinese Medicine were divided into the control group(52 cases)and the observation group(53 cases)according to the random number table method.The control group was treated with FOLFOXIRI regimen,while the observation group was treated with Cetuximab combined with FOLFOXIRI regimen.14 days were one chemotherapy cycle.Both groups were given continuous treatment for 4 chemotherapy cycles.The clinical effect was evaluated after treatment.The number and size of lesions and the levels of peripheral blood CD4+,CD8+,CD4+/CD8+,serum glycoantigen 19-9(CA19-9)and carcinoembryonic antigen(CEA)of patients in two groups were compared between before and after treatment.Survival rates of patients at 6 months,1 year,and 3 years after treatment were calculated and compared between the two groups.Results The effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The number and size of lesions of patients in both groups after treatment were significantly smaller than before treatment,and those in the observation group were significantly smaller than those in the control group,with statistically significant differences(all P<0.05).The levels of CD4+,CD8+and CD4+/CD8+in peripheral blood of patients in the two groups after treatment were significantly higher than those before treatment,and those in the observation group were significantly higher than those in the control group,with statistically significant differences(all P<0.05).Serum CA19-9 and CEA levels of patients in both groups after treatment were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group,with statistically significant differences(all P<0.05).There was no significant difference in survival rate of patients between the two groups at 6 months after treatment(P>0.05).The 1 year and 3 year survival rates in the observation group after treatment were significantly higher than those in the control group,with statistically significant differences(all P<0.05).Conclusion Cetuximab combined with FOLFOXIRI regimen has a significant clinical effect in the treatment of liver metastasis of unresectable colorectal cancer,which can improve the immune function of the body,reduce serum CA19-9 and CEA levels,and prolong the survival time of patients.