复方斑蝥胶囊联合替吉奥单药治疗晚期结直肠癌的疗效及对CEA、VEGF、CA199水平影响

Effect of Compound Cantharidin Capsule(复方斑蝥胶囊) Combined with Teggio Monotherapy on Advanced Colorectal Cancer and Its Effect on Levels of CEA,VEGF and CA199

目的探讨复方斑蝥胶囊联合替吉奥单药治疗晚期结直肠癌的疗效及对CEA、VEGF、CA199水平影响。方法选取医院收治的晚期结直肠癌患者60例,随机分为两组各30例。对照组给予替吉奥,推荐剂量为40~60 mg/次,2次/d,早晚服用,连续口服28 d,然后停用14 d为1个治疗周期;治疗组在对照组基础上口服复方斑蝥胶囊,3粒/次,2次/d。两组患者接受治疗3个月。观察两组患者治疗后的临床疗效、无进展生存期(PFS)及总生存期(OS)、CEA、VEGF、CA199水平、生活质量评分和不良反应发生情况。结果经过治疗后,对照组客观缓解率和疾病控制率分别为43.33%和36.67%,治疗组客观缓解率和疾病控制率分别为53.33%和70.00%,治疗组客观缓解率和疾病控制率高于对照组,但两组差异无统计学意义(P>0.05);两组患者治疗前KPS评分无差异(P>0.05);两组患者治疗后KPS评分明显升高(P<0.05);并且治疗组升高较多(P<0.05);两组患者治疗前血清CEA、VEGF、CA199水平差异无统计学意义(P>0.05);两组患者治疗后血清CEA、VEGF、CA199水平显著降低(P<0.05);并且治疗组降低较多(P<0.05);治疗组患者总生存时间和无进展生存时间显著高于对照组(P<0.05);治疗前两组患者免疫功能指标水平无差异(P>0.05);治疗后,对照组治CD_(3)^(+)、CD_(4)^(+)、NK、CD_(4)^(+)/CD_(8)^(+)水平明显降低(P<0.05);而治疗组明显升高(P<0.05);且治疗组免疫功能指标水平明显高于对照组(P<0.05);治疗组患者中性粒细胞减少、白细胞减少、血红蛋白减少、胃肠道反应和肝脏功能异常发生率显著低于对照组(P<0.05)。结论采用复方斑蝥胶囊联合替吉奥单药治疗晚期结直肠癌具有较好的治疗效果,能够显著提高患者生活质量,降低CEA、VEGF、CA199水平,值得在临床上推广应用。

Objective To investigate the effect of Compound Cantharidin Capsule(复方斑蝥胶囊) combined with teggio monotherapy on advanced colorectal cancer and its effect on levels of CEA, VEGF and CA199. Methods Sixty cases of advanced colorectal cancer admitted to our hospital were randomly divided into two groups, 30 cases in each. In the control group, teggio was given with the recommended dose of 40~60 mg/time and 2 times/d orally in the morning and evening, continuously for 28 days, and then discontinued for 14 days for one treatment cycle. The treatment group took Compound Cantharidin Capsule orally on the basis of the control group, 3 capsules/time, 2 times/d. Patients in both groups were treated for 3 months. The clinical efficacy, progression-free survival(PFS) and overall survival(OS), levels of CEA, VEGF and CA199, quality of life score and adverse reactions of the two groups were observed. Results After treatment, the objective remission rate and disease control rate of the control group were 43.33% and 36.37%, respectively and the objective remission rate and disease control rate of the treatment group were 53.33% and 70.00%, respectively. The objective remission rate and disease control rate of the treatment group were higher than those of the control group, but the difference between the two groups was not statistically significant(P>0.05). There was no difference in KPS score between the two groups before treatment(P>0.05). KPS score was significantly increased after treatment in both groups(P<0.05). In addition, the treatment group’s KPS score was increased significantly(P<0.05). There was no difference in serum levels of CEA, VEGF or CA199 between the two groups before treatment(P>0.05). Serum levels of CEA, VEGF and CA199 in the two groups were significantly reduced after treatment(P<0.05). In addition, there was a significant decrease in the treatment group(P<0.05). The total survival time and progression-free survival time in the treatment group were significantly higher than that in the control group(P<0.05). There was no difference in the level of immune function between the two groups before treatment(P>0.05). After treatment, the levels of CD_(3)^(+), CD_(4)^(+), NK and CD_(4)^(+)/CD_(8)^(+) in the control group were significantly reduced(P<0.05). The treatment group’s levels of CD_(3)^(+), CD_(4)^(+), NK and CD_(4)^(+)/CD_(8)^(+) were significantly increased(P<0.05). The level of immune function index in the treatment group was significantly higher than that in the control group(P<0.05). The incidence of neutropenia, leukopenia, hemoglobin reduction, gastrointestinal reaction and liver dysfunction in the treatment group was significantly lower than that in the control group(P<0.05). Conclusion Compound Cantharide Capsule combined with teggio monotherapy has a good therapeutic effect in the treatment of advanced colorectal cancer, can significantly improve the quality of life of patients, reduce levels of CEA, VEGF and CA199, and is worthy of clinical application.