西妥昔单抗分别联合XELOX、FOLFOX4方案治疗晚期结肠癌的近期疗效比较

Comparison of short-term efficacy of cetuximab combined with XELOX and FOLFOX4 schemes respectively in the treatment of advanced colon cancer

目的比较西妥昔单抗分别联合XELOX、FOLFOX4方案治疗晚期结肠癌的近期疗效。方法选取2020年5月—2022年5月大冶市中医医院收治的晚期结肠癌患者60例,根据随机数字表法分为观察组和对照组,每组30例。观察组采用西妥昔单抗联合XELOX方案治疗,对照组采用西妥昔单抗联合FOLFOX4方案治疗,2组均以21 d为1个周期,化疗8个周期。比较2组患者近期疗效,治疗前后免疫功能指标、肿瘤相关因子及不良反应。结果观察组患者客观缓解率为83.33%,高于对照组的60.00%(χ^(2)=4.022,P=0.045)。治疗8个周期后,2组患者免疫球蛋白A、M、G(IgA、IgM、IgG)水平较治疗前降低(P均<0.01),但观察组IgA、IgM、IgG水平高于对照组(P<0.05或P<0.01);2组患者血清转化生长因子-β(TGF-β)、组织抑制剂-1(TIMP-1)、血管内皮生长因子-A(VEGF-A)水平较治疗前明显降低,且观察组低于对照组(P均<0.01)。观察组与对照组不良反应总发生率比较差异无统计学意义(23.33%vs.40.00%,χ^(2)=1.926,P=0.165)。结论西妥昔单抗联合XELOX方案治疗晚期结肠癌具有更好的疗效,对患者免疫功能影响较小,可下调肿瘤相关因子水平,安全性较高。

Objective To compare the short-term efficacy of cetuximab combined with XELOX and FOLFOX4 schemes respectively in the treatment of advanced colon cancer.Methods A total of 60 patients with advanced colon cancer admitted to Daye Hospital of Traditional Chinese Medicine from May 2020 to May 2022 were selected and divided into observation group and acontrol group according to the random number table method,with 30 cases in each group.The observation group was treated with cetuximab combined with XELOX scheme,and the control group was treated with cetuximab combined with FOLFOX4 scheme.The two groups took 21 days as a cycle and 8 cycles of chemotherapy.The short-term efficacy,immune function indicators,tumor related factors,and adverse reactions were compared between the two groups.Results The objective response rate of patients in the observation group was 83.33%,higher than 60.00%in the control group(χ^(2)=4.022,P=0.045).After 8 cycles of treatment,the levels of IgA,IgM,and IgG in two groups of patients decreased compared to before treatment(P<0.01),but the levels of IgA,IgM,and IgG in the observation group were higher than those in the control group(P<0.05 or P<0.01);The levels of serum TGF-β,TIMP-1 and VEGF-A were significantly lower in the observation group than those in the control group(P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group(23.33%vs.40.00%,χ^(2)=1.926,P=0.165).Conclusion The regimen of cetuximab combined with XELOX scheme has better efficacy in the treatment of advanced colon cancer,has less impact on the immune function of patients,can lower the level of tumor related factors,and has a higher safety profile.