信迪利单抗联合XELOX方案在结直肠癌患者中的应用

Application of sintilimab combined with XELOX regimen to patients with colorectal cancer

目的探讨信迪利单抗联合XELOX方案(奥沙利铂联合卡培他滨)在结直肠癌患者中的应用效果。方法回顾性收集2021年6月至2023年3月收治的100例结直肠癌患者病历资料,根据治疗方式不同,将50例接受XELOX方案治疗患者纳入对照组,将50例接受信迪利单抗联合XELOX方案治疗患者病历资料纳入观察组。对比2组治疗前、治疗4周期后治疗效果、肿瘤标志物[癌抗原CA19-9(CA-199)、癌胚抗原(CEA)]、T细胞亚群[CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)]及化疗期间药物毒副作用[甲状腺功能异常、贫血、皮疹、骨髓抑制、恶心呕吐、肝功能损伤],以探讨信迪利单抗联合XELOX方案在结直肠癌患者中的应用效果。结果观察组客观缓解率显著高于对照组(P<0.05)。治疗后,2组CA-199、CEA水平均下降,且观察组低于对照组(P<0.05)。治疗后,观察组CD_(4)^(+)/CD_(8)^(+)、CD_(4)^(+)、CD_(3)^(+)水平高于治疗前,且高于对照组(P<0.05);对照组CD_(4)^(+)/CD_(8)^(+)、CD_(4)^(+)、CD_(3)^(+)、CD_(8)^(+)水平较治疗前差异无统计学意义(P>0.05)。观察组甲状腺功能异常、贫血等发生例数显著高于对照组(P<0.05)。结论信迪利单抗联合XELOX方案可降低结直肠癌患者肿瘤标志物水平,改善免疫功能,疗效确切且药物毒副反应在可控范围内。

Objective To investigate the effect of sintilimab combined with XELOX regimen(oxaliplatin plus capecitabine)in colorectal cancer patients.Methods The medical records of 100 colorectal cancer patients admitted from June 2021 to March 2023 were retrospectively collected.According to the different treatment methods,50 patients who received XELOX regimen were included in the control group,50 patients who received sintilimab combined with XELOX regimen were included in the observation group.The treatment effect,tumor markers(cancer antigen CA19-9[CA-199],carcinoembryonic antigen[CEA]),T-cell subsets(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))and drug side effects(thyroid dysfunction,anemia,rash,bone marrow suppression,nausea and vomiting,liver function damage)during chemotherapy were compared between the two groups before treatment and after 4 cycles of chemotherapy,thus exploring the application effect of sintilimab combined with XELOX on colorectal cancer patients.Results The objective response rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,CA-199 and CEA levels in both groups decreased,which were significantly lower in the observation group than those of the control group(P<0.05).After treatment,CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+) levels in the observation group were significantly higher than before treatment,and which were significantly higher than those of the control group(P<0.05).CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),and CD_(4)^(+)/CD_(8)^(+) levels after treatment in the control group were comparable to those before treatment(P>0.05).The number of cases of abnormal thyroid function and anemia in the observation group was significantly greater than that in the control group(P<0.05).Conclusion Sintilimab combined with XELOX regimen can reduce the levels of tumor markers in colorectal cancer patients,improve immune function,and has a definite efficacy and controllable side effects.