卡培他滨联合贝伐珠单抗治疗晚期结直肠癌的临床疗效及对患者毒副反应发生情况和生存时间的影响

Clinical efficacy of capecitabine combined with bevacizumab in the treatment of advanced colorectal cancer and influence on the occurrence of toxic side effects and survival time of patients

目的探讨卡培他滨联合贝伐珠单抗治疗晚期结直肠癌的临床疗效及对患者毒副反应发生情况和生存时间的影响。方法选取2019年6月至2021年5月于九江市第一人民医院接受治疗的86例晚期结直肠癌患者作为研究对象,按照随机数字表法分为观察组与对照组,每组43例。对照组给予卡培他滨治疗,观察组在对照组基础上联合贝伐珠单抗治疗,比较两组病灶改善情况[客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)及总生存期(OS)]、治疗前后血清肿瘤标志物(TM)[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原242(CA242)]水平、药物毒副反应发生情况及治疗前后生命质量。结果观察组ORR、DCR均高于对照组,PFS、OS均长于对照组,差异有统计学意义(P<0.05)。治疗后,两组CEA、CA19-9、CA242水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组药物毒副反应发生率比较差异无统计学意义。治疗后,两组卡诺夫斯凯计分(KPS)、生命质量量表(QOL)评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论卡培他滨联合贝伐珠单抗治疗晚期结直肠癌患者疗效显著,可明显降低患者TM水平,毒副反应发生率未升高,提高其生存质量,值得临床推广意义。

Objective To investigate the clinical efficacy of capecitabine combined with bevacizumab in the treatment of advanced colorectal cancer and influence on the occurrence of toxic side effects and survival time of patients.Methods 86 patients with advanced colorectal cancer who received treatment in Jiujiang NO.1 People's Hospital from June 2019 to May 2021 were selected as the study subjects,and they were divided into the observation group and the control group according to the random number table method,with 43 cases in each group.The control group was treated with capecitabine,and the observation group was treated with bevacizumab on the basis of the control group,the improvement of lesions(objective response rate[ORR],disease control rate[DCR],progression-free survival[PFS]and overall survival[OS]),serum tumor markers(TM)(carcinoembryonic antigen[CEA],carbohydrate antigen 19-9[CA19-9],carbohydrate antigen 242[CA242])levels before and after treatment,occurrence of drug toxic side effects and quality of life before and after treatment were compared between the two groups.Results The ORR and DCR inthe observation group were higher than those in the control group,and the median PFS and median OS were longer than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of CEA,CA19-9 and CA242 of the two groups were lower than those before treatment,and the observation group were lower in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of drug toxic side effects between the two groups.After treatment,the Kanofsky performance score(KPS)and quality of life(QOL)scores of the two groups were higher than those before treatment,and the observation group were higher than the control group,and the differences were statistically significant(P<0.05).Conclusion Capecitabine combined with bevacizumab is effective in the treatment of patients with advanced colorectal cancer,which can significantly reduce the TM level of patients,without increasing the incidence of drug toxic side effects,and improve their quality of life,which is worthy of clinical promotion and application.