阿帕替尼联合奥沙利铂、卡培他滨治疗结直肠癌的临床疗效

Clinical efficacy of apatinib combined with oxaliplatin and capecitabine in treatment of colorectal cancer

目的探讨阿帕替尼、奥沙利铂、卡培他滨三药联用对结直肠癌患者近远期预后、细胞因子及血管生成指标的影响。方法将120例ⅢB~Ⅳ期结直肠癌患者随机分为对照组和观察组,每组60例。对照组给予奥沙利铂135 mg·m^(-2)+5%葡萄糖注射液250 mL静脉滴注2 h,每3周1次,同时给予卡培他滨1.25 g·m^(-2)口服,每日2次,连续服用2周后停药1周。在对照组治疗的基础上,观察组给予阿帕替尼0.5 g口服,每日1次,共6周。比较2组患者近远期疗效、生活质量、血清细胞因子、病灶部位血管生成指标水平及不良反应发生情况。结果治疗后,观察组临床有效率、疾病控制率均高于对照组(P <0.05),且观察组总生存时间、无进展生存时间和生活质量评分均高于对照组(P <0.05)。与治疗前比较,治疗后2组肿瘤坏死因子-α、白细胞介素-2、干扰素-γ水平均升高(P <0.05),且观察组高于对照组(P <0.05)。与治疗前比较,治疗后2组血管内皮细胞生长因子受体-2、微血管密度均降低(P <0.05),且观察组低于对照组(P <0.05)。观察组和对照组不良反应发生率比较无显著差异(48%vs. 43%,P>0.05)。结论阿帕替尼联合奥沙利铂、卡培他滨治疗结直肠癌疗效较好且安全,能够延长患者生存期限,提高患者生活质量。可能与改善患者免疫功能,抑制肿瘤血管生成有关。

AIM To explore the effects of apatinib combined with oxaliplatin and capecitabine on the short-term and long-term prognosis, cytokines and angiogenesis indicators of patients with colorectal cancer. METHODS One hundred and twenty patients with stage ⅢB-Ⅳ colorectal cancer were randomly divided into control group and observation group, with 60 cases in each group. The control group was given oxaliplatin 135 mg·m^(-2) + 5% glucose injection 250 mL intravenously for 2 h, once every 3 weeks, and capecitabine 1.25 g· m^(-2), 2 times per day, continuous administration for 2 weeks followed by 1-week break. On the basis of the treatment of the control group, the observation group was given apatinib mesylate 0.5 g, 1 time per day, for a total of 6 weeks. The short-term efficacy, long-term efficacy, living quality, serum immune factor levels, the level of angiogenesis-related indicators in the lesion tissue and the incidence of adverse reactions were compared between two groups. RESULTS After the treatment, the clinical effectiveness and disease control rate of the observation group were obviously higher than those of the control group(P < 0.05), and the total survival time, progression-free survival time and life quality score of the observation group were obviously higher than those of the control group(P < 0.05). After treatment, the levels of tumor necrosis factor-α, interleukin-2, and interferon-γ in both groups were obviously higher than those before treatment(P < 0.05), and those in the observation group was obviously higher compared with the control group(P < 0.05). After treatment, the levels of vascular endothelial growth factor receptor-2 and microvessel density in both groups were obviously lower than those before treatment(P < 0.05), and those in the observation group was obviously lower compared with the control group(P < 0.05). There was no significant difference in the incidence of adverse reactions between the observation group and control group(48% vs. 43%,P > 0.05). CONCLUSION Apatinib combined with oxaliplatin and capecitabine is effective and safe in the treatment of colorectal cancer, which can prolong the survival time of patients and improve their life quality. It may be related to improving the patient’s immune function and inhibiting tumor angiogenesis.