A Multicenter Cohort Study for XELOX (Capecitabine, Leucovorin plus Oxaliplatin) Therapy as First-Line Treatment in Elderly Patients with Unresectable Colorectal Cancer

Oxaliplatin-based chemotherapy with bevacizumab is now widely used for colorectal cancer patients. This study evaluated the efficacy and tolerability of XELOX (capecitabine + oxaliplatin + leucovorin combined) therapy with or without bevacizumab in elderly patients. One hundred and seven patients, consisting of 52 elderly (>70 years of age) and 55 non-elderly, with unresectable colorectal cancer were enrolled in this multicenter cooperative group study using a database between October 2009 and March 2012. We evaluated the outcomes in terms of the median time to treat failure (TTF), overall response rate (ORR), disease control rate (DCR) and tolerability in both age groups. The median TTF for the XELOX + bevacizumab regimen was 7.1 months in the non-elderly group and 8.1 months in the elderly group (p = 0.838). There was no significant difference in TTF between the two groups. The ORR and DCR in the non-elderly group were 30.8% and 73.1%, respectively. In the elderly group, the ORR was 40.0% and the overall DCR was 90.0%. No severe or uncontrollable adverse events were observed in the two groups. These data indicated that the XELOX chemotherapy with or without bevacizumab has an equivalent efficacy in both groups, without increasing the adverse events even in the elderly population.

信迪利单抗联合XELOX方案在结直肠癌患者中的应用

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。

CEA、CA125、CA199评估贝伐单抗靶向治疗联合XELOX辅助化疗方案对晚期结直肠癌的效果

目的探讨癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原199(CA199)联合检测评估贝伐单抗靶向治疗联合奥沙利铂和卡培他滨(XELOX)辅助化疗方案对晚期结直肠癌患者疗效及预后的效果。方法择取2019年3月至2020年3月就诊的晚期结直肠癌患者共计72例作研究对象,依照计算机随机分组模式归纳为对照组(36例,XELOX化疗)与试验组(36例,贝伐单抗+XELOX化疗),对比2组的临床疗效、短期生存率、血清指标水平、不良反应发生率。结果试验组与对照组的临床控制率分别为88.89%与66.67%,差异有统计学意义(P<0.05);试验组1年、2年生存率分别为91.67%与77.78%,均明显高于对照组(P<0.05);治疗前,2组血清CEA、CA125、CA199水平均无明显差异无统计学意义(P>0.05),治疗后,试验组上述指标水平均明显低于对照组(P<0.05);2组不良反应发生率均差异无统计学意义(P>0.05)。结论对晚期结直肠癌患者给予贝伐单抗+XELOX辅助化疗具有明显的临床疗效,帮助患者有效延长生存周期,降低血清指标水平,药效可靠,值得采纳。

Evaluating combined bevacizumab and XELOX in advanced colorectal cancer: Serum markers carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 199 analysis

BACKGROUND Colorectal cancer ranks third and second among common and fatal cancers.The treatment of metastatic colorectal cancer(mCRC)is generally based on XELOX in clinical practice,which includes capecitabine(CAP)and oxaliplatin.Serum tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125 and CA199 are prognostic factors for various tumors.AIM To investigate evaluating combined bevacizumab(BEV)and XELOX in advanced colorectal cancer:Serum markers CEA,CA125,CA199 analysis.METHODS In this retrospective study,a total of 94 elderly patients diagnosed with mCRC were recruited and subsequently categorized into two groups based on the distinct treatment modalities they received.The control group was treated with XELOX plus CAP(n=47),while the observation group was treated with XELOX plus CAP and BEV(n=47).Several indexes were assessed in both groups,including disease control rate(DCR),incidence of adverse effects,serum marker levels(CEA,CA125,and CA19)and progression-free survival(PFS).RESULTS After 9 wk of treatment,the serum levels of CEA,CA199 and CA125 in the observation group were significantly lower than those in the control group(P<0.05).Moreover,the PFS of the observation group(9.12±0.90 mo)was significantly longer than that of the control group(6.49±0.64 mo).Meanwhile,there was no statistically significant difference in the incidence of adverse reactions and DCR between the two groups during maintenance therapy(P>0.05).CONCLUSION On the basis of XELOX treatment,the combination of BEV and CAP can reduce serum tumor marker levels and prolong PFS in patients with mCRC.

Long-term efficacy of capecitabine plus oxaliplatin chemotherapy on stage Ⅲ colon cancer: A meta-analysis

BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.

Clinical observation of capecitabine plus oxaliplatin in treatment of 68 cases with advanced gastric cancer

Objective:The aim of this study was to evaluate the response rate,time to progression(TTP),overall survival,and safety of the combination of capecitabine plus oxaliplatin in treatment of advanced gastric cancer(AGC).Methods:All the patients with advanced gastric cancer who were not received any prior chemotherapy or radiotherapy were treated with combination of capecitabine(1250 mg/m2 twice daily,days 1-14) plus oxaliplatin(130 mg/m2 as a 2-h intravenous infusion on day 1) every 3 weeks.Results:Two cases of complete response(CR) and 34 cases of partial response(PR) were confirmed,giving an overall response rate of 52.9%,of the 68 patients with advanced gastric cancer.The median TTP and overall survival for all patients were 7.3 and 11.9 months,respectively.Grade 3 leukopenia,thrombocytopenia,nausea/vomiting,and diarrhea were observed in 3,5,1,and 4 patients,respectively.Yet,no grade 4 toxicity was observed.Conclusion:Capecitabine/ oxaliplatin combination chemotherapy is active in patients with advanced gastric cancer.

贝伐珠单抗联合XELOX化疗治疗晚期结直肠癌的临床观察

目的探讨贝伐珠单抗联合奥沙利铂+卡培他滨(XELOX)化疗对晚期结直肠癌(CRC)患者的疗效。方法92例晚期CRC患者,根据随机分组法分为观察组(48例)和对照组(44例)。对照组患者给予XELOX化疗方案,观察组患者在对照组治疗基础上加用贝伐珠单抗治疗。比较两组临床疗效、治疗前后肿瘤标志物[糖类抗原242(CA242)、癌胚抗原(CEA)、糖类抗原199(CA199)]、不良反应(头晕、厌食、腹胀、呕吐)发生情况。结果疗程结束后,观察组患者客观缓解率31.25%、疾病控制率70.83%均明显高于对照组的13.64%、50.00%(P<0.05)。治疗后,观察组患者CA242为(34.38±3.16)IU/ml、CEA为(19.94±1.15)μg/L、CA199为(33.52±3.25)U/ml,对照组患者CA242为(44.24±4.23)IU/ml、CEA为(31.14±1.33)μg/L、CA199为(58.16±3.32)U/ml。治疗后,两组患者CA242、CEA、CA199水平均较治疗前显著下降,且观察组患者下降幅度高于对照组(P<0.05)。两组不良反应发生率对比,未见显著差异(P>0.05)。结论贝伐珠单抗同XELOX化疗联合能够显著提高晚期CRC患者临床疗效,同时有助于降低血清CA242、CEA、CA199在体内的表达,提高疾病缓解率和控制率,与单用XELOX化疗相比,没有增加明显不良反应,安全可靠。

信迪利单抗联合XELOX方案治疗晚期胃癌的有效性及安全性分析

目的探讨信迪利单抗、奥沙利铂联合卡培他滨(XELOX)方案治疗晚期胃癌的效果。方法选取2022年10月—2023年8月我院收治的76例晚期胃癌患者为研究对象,根据随机数字表法将其分为对照组和观察组,各38例。对照组采用XELOX方案治疗,观察组在此基础上加用信迪利单抗。比较两组的肿瘤标志物水平、毒副反应。结果经6个周期治疗后,观察组控制率高于对照组,差异有统计学意义(P<0.05);两组血清癌胚抗原、糖类抗原724及糖类抗原125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);治疗期间,两组患者毒副反应比较,差异无统计学意义(P>0.05)。结论信迪利单抗联合XELOX方案治疗晚期胃癌的效果良好,可有效改善患者肿瘤代谢指标,有一定的安全性。

贝伐单抗联合Xelox方案治疗局部晚期结肠癌患者的效果观察

目的:观察贝伐单抗联合Xelox方案(奥沙利铂^(+)卡培他滨)在局部晚期结肠癌患者治疗中的应用效果。方法:选取2021年1月—2023年5月临沂市中心医院肿瘤科收治的局部晚期结肠癌患者中60例,采用随机数字表法分为对照组与观察组各30例。对照组患者静脉滴注奥沙利铂,并口服卡培他滨片治疗;观察组患者在对照组治疗的基础上口服贝伐珠单抗治疗。比较两组临床疗效、血清免疫指标、血清肿瘤标志物水平及不良反应。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD4^(+)及CD4^(+)/CD8^(+)水平均高于治疗前,且观察组CD4^(+)及CD4^(+)/CD8^(+)水平均高于对照组,差异有统计学意义(P<0.05);两组血清癌胚抗原(CEA)及糖类抗原199(CA199)水平低于治疗前,且观察组CEA、CA199水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:贝伐单抗联合Xelox方案可有效提升局部晚期结肠癌患者的临床疗效,改善患者的血清免疫指标,调节血清肿瘤标志物,且安全性较好。

复方苦参注射液联合XELOX化疗对结直肠癌术后患者临床疗效的观察

目的探讨复方苦参注射液联合卡培他滨^(+)奥沙利铂(capecitabine plus oxaliplatin,XELOX)化疗对结直肠癌术后患者的临床疗效。方法选取2020年1月至2021年12月天津中医药大学第二附属医院普通外科手术后结直肠癌患者70例,根据随机数字表法分为对照组和干预组,每组35例。对照组仅采用XELOX化疗;干预组在对照组基础上加用复方苦参注射液(规格5 ml/支,国药准字Z14021231)20 ml^(+)250 ml生理盐水静脉滴注,每天1次,连用14 d,停用7 d。两组均以3周为1个疗程,连续6个疗程。比较两组治疗前后外周血T淋巴细胞亚群、CEA水平及不良反应发生率。结果治疗后,干预组CD3^(+)、CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平且显著高于对照组[(78.74±6.16)比(67.94±5.35),(51.33±9.39)比(37.89±4.91),(2.84±1.35)比(1.24±0.30)],差异均有统计学意义(P<0.05)。治疗后,干预组血清CEA水平显著低于对照组[(29.30±14.90)ng/ml比(58.01±19.07)ng/ml],差异有统计学意义(P<0.05)。治疗后,干预组骨髓抑制、胃肠道反应、肝肾功能异常的发生率均低于对照组(17.1%比42.9%,31.4%比57.1%,14.3%比37.1%),差异均有统计学意义(P<0.05)。结论复方苦参注射液联合XELOX化疗对结直肠癌术后患者免疫力具有较好疗效,且降低了化疗引起的不良反应发生率。

卡瑞利珠单抗联合XELOX化疗方案在晚期肝癌患者中的应用效果

目的 评价卡瑞利珠单抗联合XELOX化疗方案在晚期肝癌患者中的应用效果。方法 回顾性分析郑州市第三人民医院在2019年6月至2021年12月收治的82例晚期肝癌患者临床资料,根据治疗方法将患者分为对照组(XELOX化疗,41例)和观察组(卡瑞利珠单抗联合XELOX化疗,41例)。两组患者均完成12个月的随访,以治疗3个周期为评价节点,评价指标为近期疗效、肿瘤标志物[甲胎蛋白(AFP)、癌胚抗原(CEA)]、毒副反应以及12个月内生存情况。结果 观察组疾病控制率高于对照组(P<0.05);治疗后,两组AFP、CEA均较治疗前降低,且观察组低于对照组(P<0.05);两组治疗期间毒副反应总发生率比较,差异无统计学意义(P>0.05);随访12个月,观察组总体生存时间长于对照组(P<0.05)。结论 卡瑞利珠单抗联合XELOX化疗方案治疗晚期肝癌患者的近期疗效较好,可降低肿瘤标志物水平,延长生存期,且安全性好。

Efficacy of capecitabine and oxaliplatin regimen for extrahepatic metastasis of hepatocellular carcinoma following local treatments

AIM: To investigate the efficacy and safety of capecitabine and oxaliplatin (CapeOx) for extrahepatic metastasis after local treatment of hepatocellular carcinoma (HCC). METHODS: Thirty-two patients with extrahepatic metastasis of HCC after local treatment were prospectively enrolled. The CapeOx regimen consisted of capecitabine 1000 mg/m 2 taken orally twice daily on days 1-14, and oxaliplatin was administered at a total dose of 100 mg/m 2 on day 1. The treatment was repeated every 3 wk until disease progression or unaccetablle toxicity. Efficacy and safety were assessable for all enrolled patients. The primary objective of this study was to assess the overall response rate. The secondary objectives were to evaluate the overall survival (OS), the time to tumor progression (TTP) and the toxicity profile of the combined strategy. TTP and OS were assessed by the Kaplan-Meier method and differences between the curves were analyzed using the log-rank test. The statistical software SPSS version 15.0 for Windows (SPSS Inc., Chicago, IL, United States) was used for statistical analysis. All P values were 2-tailed, with statistical significance defined byP ≤ 0.05. RESULTS: Thirty-two patients were assessable for efficacy and toxicity. The median follow-up duration was 15 mo (range, 12-20 mo). At the cut-off date of March 31, 2012, 27 patients died due to tumor progression and one patient died of myocardial infarction. Four patients were still alive (three patients with disease progression). OR was 21.9% (n = 7), the stabilization rate was 40.6% (n = 13), and the disease control rate was 62.5%. The responses lasted from 4 to 19 mo (median, 6 mo). Median TTP was 4.2 mo (95%CI: 2.5-7.4), and the median OS time was 9.2 mo (95%CI: 6.5-17.8). The 1-year survival rate was 43.6% (95%CI: 29.0-66.0). In a multivariate analysis, OS was significantly longer in patients with a Child-Pugh class A compared with class B patients (P = 0.014), with a median OS of 10.1 mo vs 5.4 mo, and there were trends towards longer OS (P = 0.065) in patients without portal vein tumor thrombosis. There were no significant effects of age, gender, performance status, cirrhosis, metastatic sites, and level of alpha fetoprotein (AFP) or hepatitis B virus-DNA on OS. Among the 22 patients with elevated AFP levels at baseline (≥ 400 ng/mL), the level fell by more than 50% during treatment in 6 patients (27.3%). The most frequent treatment-related grade 3 to 4 toxicities included leucopenia/neutropenia, transient elevation of aminotransferases, handfoot syndrome and fatigue. CONCLUSION: CapeOx showed modest anti-tumor activity in metastatic HCC. However, the manageable toxicity profile and the encouraging disease control rate deserve further study for these patients.

Adjuvant chemotherapy with S-1 plus oxaliplatin improves survival of patients with gastric cancer after D2 gastrectomy: A multicenter propensity score-matched study

AIM To investigate the safety and efficacy of S-1 plus oxaliplatin(SOX) as an adjuvant chemotherapy regimen in gastric cancer(GC) after D2 dissection.METHODS GC Patients who underwent D2 gastrectomy from September 2009 to December 2011 in four Chinese institutions were enrolled. Patients with stage ⅠB-ⅢC GC, who received adjuvant SOX treatment were matched by propensity scores with those who underwent surgery alone and those who conducted capecitabine plus oxaliplatin(XELOX) regimen. Disease-free survival(DFS) and overall survival(OS) were compared among the groups. In addition, adverse events in SOX patients were analyzed.Of 1944 GC patients who underwent D2 dissection, 867 were included for analysis. One hundred and seventeen patients treated with SOX were matched to 234 patients who conducted surgery alone. Fifty-seven patients treated with SOX were matched to 57 patients who received XELOX. The estimated five-year DFS was 57.5% in the adjuvant SOX group which was higher than that(44.6%) in the surgery alone group(P = 0.001); and the estimated five-year OS was 68.3% which was higher than that(45.8%) of surgery alone group(P < 0.001). Survival benefit was also revealed in stage III and > 60 years old subgroups(P < 0.001 and P = 0.015, respectively). Compared with XELOX regimen, SOX showed no significant difference in DFS(P = 0.340) and OS(P = 0.361). The most common ≥ 3 grade adverse events of SOX regimen were neutropenia(22.6%), leukopenia(8.9%) and thrombocytopenia(5.6%).CONCLUSION Compared with surgery alone, SOX regimen significantly improves the long-term survival and has acceptable toxicity in patients with stage ⅠB-ⅢC GC after D2 dissection. It may be a novel adjuvant chemotherapy regimen in GC patients.

Surgical resection of advanced gastric cancer following trastuzumab/oxaliplatin/capecitabine combination therapy

Late-stage gastric adenocarcinoma patients have a poor prognosis because of high recurrence rates. To improve long-term outcomes, perioperative chemotherapies are combined with surgery. Human epidermal growth factor receptor 2 (HER2) overexpression had been noted in gastric cancer; therefore, trastuzumab has been used occasionally in this setting. A 63-year-old male Chinese patient, who was diagnosed with adenocarcinoma in the gastric antrum, as well as lymph node metastases along the left gastric and hepatic artery, and left adrenal area, was admitted to our hospital. HER2 expression was positive, and cluster amplification was detected in a fluorescence in situ hybridization assay. The patient received three cycles of a neoadjuvant trastuzumab/oxaliplatin /capecitabine regimen. He subsequently underwent distal gastrectomy, D2+ lymphadenectomy, left adrenalectomy, cholecystectomy and Billroth II anastomosis. Treatment was continued with another five postoperative cycles of the same medication and trastuzumab application for 1 year. No recurrence has been observed 18 mo after the operation. Trastuzumab as perioperative and adjuvant medication, in combination with oxaliplatin and capecitabine for a HER2-overexpressing advanced gastric adenocarcinoma, led to recurrence-free survival of at least 18 mo after surgery.

Combined treatment of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer

AIM:To investigate the efficacy and side effects of the combined therapy of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer(ESCC) and the survival of the patients.METHODS:Sixty-four patients(median age of 63 years) with histological or cytological confirmation of ESCC received oxaliplatin 120 mg/m2 intravenously on day 1 and capecitabine 1000 mg/m2 orally twice daily on days 1 to 14 in a 21-d treatment cycle as palliative chemotherapy.Each patient received at least two cycles of treatment.The efficacy,side effects and patient survival were evaluated.RESULTS:The partial response(PR) rate was 43.8%(28/64).Stable disease(SD) rate was 47.9%(26/64),and disease progression rate was 15.6%(10/64).The clinical benefit rate(PR + SD) was 84.4%.The main toxicities were leukopenia(50.0%),nausea and vomiting(51.6%),diarrhea(50.0%),stomatitis(39.1%),polyneuropathy(37.5%) and hand-foot syndrome(37.5%).No grade 4 event in the entire cohort was found.The median progression-free survival was 4 mo,median overall survival was 10 mo(95% CI:8.3-11.7 mo),and the 1-and 2-year survival rates were 38.1% and 8.2%,respectively.High Karnofsky index,single metastatic lesion and response to the regimen indicated respectively good prognosis.CONCLUSION:Oxaliplatin plus capecitabine regimen is effective and tolerable in metastatic ESCC patients.The regimen has improved the survival moderately and merits further studies.

Capecitabine and Oxaliplatin versus 5-Fluorouracil in the Neoadjuvant Chemoradiation for Patients with Locally Advanced Rectal Carcinoma: A Comparative Study

Aim of work: This study aimed to evaluate the resectability rate, rate of conservative surgery, toxicity, local control, and disease free survival for oxaliplatin and capecitabine based chemoradiation compared to standard 5-FU based chemoradiation in locally advanced cancer rectum. Patients and methods: 65 patients were eligible;33 patients received oxaliplatin and capecitabine based chemoradiation (arm I) and 32 patients received 5-FU based chemoradiation (arm II). Results: The overall response rate in arms I and II were 78.7% and 87.5% respectively. Conservative surgery was done in 81.81% and 53.13% of patients with arms I and II, pathologic complete response (pCR) rate was significantly better in arm I than arm II (30.3% vs. 21.9%, P < 0.01). 3-year recurrence rates were 54.5% and 56.2% in arms I, II respectively;the median disease free survival (DFS) were 30 months and 15 months in arms I and II respectively. Grade III anemia, grade IV diarrhea and severe proctitis were developed in a significantly large number of patients with arm I;in addition deep venous thrombosis (DVT) was developed in 15.15% of patients with arm I but none in arm II. Conclusion: The addition of oxaliplatin to the preoperative chemo radiation increased the response rate mainly pCR rate which was considered a target goal in the neoadjuvant treatment, but it was not recommended because of higher toxicity and no significant effect on DFS in different response groups of arm I when compared to arm II, but longer follow up may be needed to evaluate the overall survival.

XELOX方案新辅助化疗联合腹腔镜胃癌根治术治疗进展期胃癌患者的效果

目的:观察XELOX方案新辅助化疗联合腹腔镜胃癌根治术治疗进展期胃癌患者的效果。方法:回顾性分析2020年11月至2021年10月该院收治的80例进展期胃癌患者的临床资料,按术前是否行新辅助化疗将其分为对照组和研究组各40例。对照组采用腹腔镜胃癌根治术治疗,研究组于腹腔镜胃癌根治术前行XELOX方案(奥沙利铂+卡培他滨)化疗。比较两组手术相关指标(手术时间、术中出血量和住院时间)水平,治疗前后血清肿瘤标志物[糖类抗原242(CA242)、糖类抗原19-9(CA19-9)和癌胚抗原(CEA)]水平,术后1年生存率、复发率,以及不良事件发生率。结果:研究组手术时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);治疗后,两组血清CA242、CA19-9和CEA水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组术后1年生存率为95.00%(38/40),高于对照组的80.00%(32/40),复发率为5.00%(2/40),低于对照组的22.50%(9/40),差异均有统计学意义(P<0.05);两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论:XELOX方案新辅助化疗联合腹腔镜胃癌根治术治疗进展期胃癌患者可缩短手术时间、住院时间,减少术中出血量,降低血清肿瘤标志物水平和复发率,提高术后1年生存率,效果优于单纯腹腔镜胃癌根治术治疗。

曲妥珠单抗联合XELOX方案治疗HER2阳性晚期转移性胃癌患者的效果

目的:观察曲妥珠单抗联合XELOX方案治疗人表皮生长因子受体2(HER2)阳性晚期转移性胃癌患者的效果。方法:选取2018年10月至2020年10月该院收治的64例HER2阳性晚期转移性胃癌患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各32例。对照组采用XELOX方案(奥沙利铂+卡培他滨)化疗,观察组在对照组基础上加用曲妥珠单抗治疗,比较两组客观缓解率(ORR)、疾病控制率(DCR)、治疗前后血清肿瘤标志物[糖类抗原19-9(CA19-9)、CA72-4和癌胚抗原(CEA)]水平,以及不良反应发生情况。结果:观察组ORR和DCR分别为46.88%(15/32)、90.62%(29/32),高于对照组的21.88%(7/32)、59.38%(19/32),差异均有统计学意义(P<0.05);治疗后,两组CA19-9、CEA、CA74-2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);两组腹泻、手足综合征、周围神经毒性、肾功能损害、肝功能损害、恶心呕吐、血红蛋白减少、血小板减少及白细胞减少等不良反应发生情况比较,差异均无统计学意义(P>0.05)。结论:曲妥珠单抗联合XELOX方案治疗HER2阳性晚期转移性胃癌患者可提高ORR和DCR,降低血清肿瘤标志物水平,效果优于单纯XELOX方案治疗。

健脾益肾方联合XELOX方案治疗胃癌气虚质临床疗效观察

目的:探究健脾益肾方联合奥沙利铂+卡培他滨(XELOX方案)对胃癌气虚质患者免疫功能、生活能力及毒副反应的影响。方法:将80例胃癌气虚质患者,随机分为两组,每组40例。对照组给予XELOX方案治疗,治疗组在对照组基础上加用健脾益肾方治疗。对比两组患者治疗前后临床总有效率、中医证候评分及生活质量改善情况、毒副反应发生率以及免疫功能。结果:治疗组患者治疗后临床总有效率优于对照组(P<0.05),差异有统计学意义。两组患者治疗后中医证候评分均低于本组治疗前,且治疗组治疗后中医证候评分明显低于对照组(P<0.01),差异具有统计学意义。两组患者治疗后CD3^(+)、CD4^(+)、CD8^(+)与本组治疗前相比差异有统计学意义(P<0.01);治疗组治疗后CD3^(+)、CD4^(+)、CD8^(+)与对照组比较差异有统计学意义(P<0.01)。治疗后治疗组胃肠道反应及骨髓抑制发生率均较对照组低(P<0.05),差异有统计学意义,两组间肝肾功能异常发生率比较差异无统计学意义(P>0.05)。结论:健脾益肾方联合XELOX方案对胃癌患者的临床总有效率、中医证候评分、生活质量、机体免疫功能均有改善,毒副反应发生率显著降低。

帕博利珠单抗联合XELOX治疗胃癌临床观察

目的探讨帕博利珠单抗联合XELOX(卡培他滨+奥沙利铂)治疗胃癌的临床疗效,以及对患者生存率及T淋巴细胞水平的影响。方法选取医院2019年2月至2022年2月收治的胃癌患者88例,按抽签法随机分为观察组和对照组,各44例。对照组予XELOX方案化学治疗(简称化疗),观察组予帕博利珠单抗+XELOX方案化疗,两组患者均以3周为1个疗程。结果观察组客观缓解率和疾病控制率分别为72.73%和95.45%,均显著高于对照组的47.73%和79.55%(P<0.05)。化疗后,两组患者的T淋巴细胞亚群CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)水平均显著升高(P<0.05),CD_(8)^(+)水平显著降低(P<0.05),且观察组显著优于对照组(P<0.05);两组患者测定量表体系之胃癌量表(QLICP-ST)的各项评分均显著升高(P<0.05),且观察组显著高于对照组(P<0.05)。观察组和对照组不良反应发生率相当(72.73%比56.82%,P>0.05)。Kaplan-Meier生存分析显示,观察组和对照组随访期间累积生存率相当(92.50%比82.93%,P=0.176)。结论帕博利珠单抗联合XELOX治疗胃癌的临床疗效良好,可有效改善患者的T淋巴细胞亚群水平,增强免疫力,提高生命质量,且安全性良好。