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...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。展开更多
目的观察XELOX方案联合华蟾素胶囊治疗晚期结直肠癌(CRC)的临床效果及安全性。方法将62例晚期CRC患者随机分为对照组与治疗组,各31例。对照组单纯给予XELOX(卡培他滨+奥沙利铂)化疗方案,治疗组在对照组基础上给予华蟾素胶囊治疗。采用RE...目的观察XELOX方案联合华蟾素胶囊治疗晚期结直肠癌(CRC)的临床效果及安全性。方法将62例晚期CRC患者随机分为对照组与治疗组,各31例。对照组单纯给予XELOX(卡培他滨+奥沙利铂)化疗方案,治疗组在对照组基础上给予华蟾素胶囊治疗。采用RECIST 1.1疗效评价系统比较两组临床疗效;比较两组治疗前、后CA199、CEA水平;按照CTCAE v 4.0对两组不良反应进行分级并评价;采用VAS评分比较两组患者疼痛缓解程度,采用KPS评分比较两组功能改善程度。结果治疗组ORR为67.74%,明显高于对照组的41.94%(P<0.05)。治疗后,两组血清CEA、CA199水平显著降低,且治疗组低于对照组(P<0.05)。治疗组Ⅰ~Ⅳ级胃肠道反应、骨髓抑制、肝功能损害、周围神经损害总发生率低于对照组(P<0.05)。治疗后,两组VAS评分明显降低,KPS评分明显升高,且治疗组优于对照组(P<0.05)。结论XELOX方案联合华蟾素胶囊治疗晚期CRC的临床效果明确,可降低毒副反应发生率,提升治疗的安全性,值得临床推广。展开更多
Background:A fixed 8-cycle oxaliplatin and capecitabine(XELOX)regimen has been the standard adjuvant therapy for patients with stage III colon cancer.However,completing the full-cycle of oxaliplatin is often associate...Background:A fixed 8-cycle oxaliplatin and capecitabine(XELOX)regimen has been the standard adjuvant therapy for patients with stage III colon cancer.However,completing the full-cycle of oxaliplatin is often associated with severe neurotoxicity.To spare patients from the toxic effects,without comprising the required efficacy,we evaluated the safety and efficacy of a modified XELOX(mXELOX)adjuvant chemotherapy regimen with 6 cycles of oxaliplatin and a full cycle of capecitabine.Methods:We retrospectively analyzed 330 eligible patients with stage III colon cancer who underwent cura-tive tumor resection followed by mXELOX,standard XELOX or unfinished XELOX adjuvant chemotherapy between December 2007 and April 2015.Associated prognostic factors were investigated and their disease-free survival(DFS)and overall survival(OS)rates were also determined and compared among the different regimen groups.Results:Compared with the standard XELOX group,the mXELOX group had lower total incidence rates of neuro-toxicity(39.3%vs.76.2%,P<0.001),leucopenia(53.6%vs.69.8%,P=0.017)and thrombocytopenia(38.1%vs.56.3%,P=0.011).The standard XELOX and mXELOX adjuvant chemotherapy regimens presented with comparable 3-year DFS rates(86.3%vs.89.2%;P=0.838)and 3-year OS rates(92.7%vs.97.6%;P=0.227).Compared to unfinished XELOX chemotherapy,the oncologic benefits of the mXELOX regimen were greater for patients with T4 tumors(3-year DFS:Hazard ratio[HR],2.184;95%confidence interval[CI],1.051-4.540;P=0.036;3-year OS:HR,4.529;95%CI 1.245-16.479;P=0.022)and for high-risk patients(3-year DFS:HR,1.962;95%CI 0.964-3.993;P=0.044;3-year OS:HR,4.193;95%CI 1.182-14.874;P=0.026).Conclusions:The mXELOX adjuvant chemotherapy presented a comparable survival benefit and lower incidence of toxicity than standard XELOX chemotherapy.It could be an alternative treatment for high-risk patients with operated stage III colon cancer.展开更多
文摘目的观察XELOX方案联合华蟾素胶囊治疗晚期结直肠癌(CRC)的临床效果及安全性。方法将62例晚期CRC患者随机分为对照组与治疗组,各31例。对照组单纯给予XELOX(卡培他滨+奥沙利铂)化疗方案,治疗组在对照组基础上给予华蟾素胶囊治疗。采用RECIST 1.1疗效评价系统比较两组临床疗效;比较两组治疗前、后CA199、CEA水平;按照CTCAE v 4.0对两组不良反应进行分级并评价;采用VAS评分比较两组患者疼痛缓解程度,采用KPS评分比较两组功能改善程度。结果治疗组ORR为67.74%,明显高于对照组的41.94%(P<0.05)。治疗后,两组血清CEA、CA199水平显著降低,且治疗组低于对照组(P<0.05)。治疗组Ⅰ~Ⅳ级胃肠道反应、骨髓抑制、肝功能损害、周围神经损害总发生率低于对照组(P<0.05)。治疗后,两组VAS评分明显降低,KPS评分明显升高,且治疗组优于对照组(P<0.05)。结论XELOX方案联合华蟾素胶囊治疗晚期CRC的临床效果明确,可降低毒副反应发生率,提升治疗的安全性,值得临床推广。
基金This work was funded by grants from National Natural Science Foundation of China(Grant No.81772595)Sun Yat-sen University Clinical Research 5010 Program(2015024)+1 种基金Sun Yat-sen University Clinical Research 5010 Program(2013013)Guangzhou Science and Technology Plan Projects(Health Medical Collaborative Innovation Program of Guangzhou)(Grant No.201803040019)
文摘Background:A fixed 8-cycle oxaliplatin and capecitabine(XELOX)regimen has been the standard adjuvant therapy for patients with stage III colon cancer.However,completing the full-cycle of oxaliplatin is often associated with severe neurotoxicity.To spare patients from the toxic effects,without comprising the required efficacy,we evaluated the safety and efficacy of a modified XELOX(mXELOX)adjuvant chemotherapy regimen with 6 cycles of oxaliplatin and a full cycle of capecitabine.Methods:We retrospectively analyzed 330 eligible patients with stage III colon cancer who underwent cura-tive tumor resection followed by mXELOX,standard XELOX or unfinished XELOX adjuvant chemotherapy between December 2007 and April 2015.Associated prognostic factors were investigated and their disease-free survival(DFS)and overall survival(OS)rates were also determined and compared among the different regimen groups.Results:Compared with the standard XELOX group,the mXELOX group had lower total incidence rates of neuro-toxicity(39.3%vs.76.2%,P<0.001),leucopenia(53.6%vs.69.8%,P=0.017)and thrombocytopenia(38.1%vs.56.3%,P=0.011).The standard XELOX and mXELOX adjuvant chemotherapy regimens presented with comparable 3-year DFS rates(86.3%vs.89.2%;P=0.838)and 3-year OS rates(92.7%vs.97.6%;P=0.227).Compared to unfinished XELOX chemotherapy,the oncologic benefits of the mXELOX regimen were greater for patients with T4 tumors(3-year DFS:Hazard ratio[HR],2.184;95%confidence interval[CI],1.051-4.540;P=0.036;3-year OS:HR,4.529;95%CI 1.245-16.479;P=0.022)and for high-risk patients(3-year DFS:HR,1.962;95%CI 0.964-3.993;P=0.044;3-year OS:HR,4.193;95%CI 1.182-14.874;P=0.026).Conclusions:The mXELOX adjuvant chemotherapy presented a comparable survival benefit and lower incidence of toxicity than standard XELOX chemotherapy.It could be an alternative treatment for high-risk patients with operated stage III colon cancer.
