贝伐珠单抗联合卡培他滨维持对晚期结肠癌患者的疗效

Effects of bevacizumab combined with capecitabine in patients with advanced colon cancer

目的探究贝伐珠单抗联合卡培他滨维持对晚期结肠癌患者预后及血清肿瘤标志物水平的影响。方法回顾性分析收治的晚期结肠癌患者60例,按照治疗方式分为卡培他滨组(n=28)和联合用药组(n=32)。卡培他滨组用卡培他滨与奥沙利铂治疗,联合用药组在卡培他滨组用药基础上联合贝伐珠单抗治疗。21 d为1个疗程,共治疗4个疗程。比较2组的临床有效率、肿瘤标志物水平[糖类抗原242(carbohydrate antigen 242,CA242)、癌胚抗原(carcinoembryonic antigen,CEA)和糖类多肽抗原199(carbohydrate antigen 199,CA19-9)]、免疫功能[调节性T细胞17(T helper cell 17,Th17)、辅助性T细胞(regulatory T cells,Treg)和Th17/Treg]、生存预后情况及不良反应发生情况。结果联合用药组的临床控制率(84.38%)高于卡培他滨组(60.71%),P<0.05;治疗后,2组的CA242、CEA和CA19-9水平均下降,且联合用药组低于卡培他滨组(P<0.05);2组Treg水平均降低,且联合用药组更低(P<0.05),2组的Th17和Th17/Treg水平均升高,且联合用药组更高(P<0.05);随访期间,联合用药组的复发率(4.55%)和转移率(2.27%)均明显低于卡培他滨组(20.93%、18.60%),1年生存率(78.13%)高于卡培他滨组(53.57%),P<0.05;治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论贝伐珠单抗联合卡培他滨能够改善晚期结肠癌患者的预后,增强患者的免疫力,降低肿瘤标志物血清水平,且安全性高。

Objective To explore the effects of bevacizumab combined with capecitabine on the prognosis and serum tumor markers in patients with advanced colon cancer.Methods A total of 60 patients with advanced colon cancer were retrospectively analyzed.According to different treatment methods,the patients were divided into a capecitabine group(n=28,receiving capecitabine+oxaliplatin)and a combined medication group(n=32,receiving bevacizumab on the basis of capecitabine group).All were treated for 4 courses(21 days/course).The clinical response rate,the levels of tumor markers[carbohydrate antigen 242(CA242),carcinoembryonic antigen(CEA),and carbohydrate polypeptide antigen 199(CA19-9)],the immune function indexes[regulatory T cells(Th17),helper T cells(Treg),and Th17/Treg],the survival prognosis and adverse reactions were compared between the 2 groups.Results The clinical control rate in the combined medication group was higher than that in the capecitabine group(84.38%vs.60.71%,P<0.05).After treatment,the levels of CA242,CEA and CA19-9 in both groups were decreased,and the combined medication group lower than the capecitabine group(P<0.05).After treatment,the levels of Treg in both groups were decreased,the combined medication group lower than the capecitabine group(P<0.05),while the Th17 and Th17/Treg was increased,the combined medication group higher than the capecitabine group(P<0.05).During follow-up,the recurrence rate and metastasis rate in the combined medication group were 4.55%and 2.27%respectively,significantly lower than those in the capecitabine group(20.93%,18.60%),and 1-year survival rate was higher than that in the capecitabine group(78.13%vs.53.57%,P<0.05).During treatment,there was no significant difference in adverse reactions between the 2 groups(P>0.05).Conclusion Bevacizumab combined with capecitabine can improve prognosis,enhance immunity and reduce the levels of serum tumor markers in patients with advanced colon cancer,with high safety.