小剂量分次放疗增敏化疗在转移性结直肠癌治疗中的临床研究  

Clinical study of low dose fractionated radiotherapy sensitization chemotherapy in the treatment of metastatic colorectal cancer

作　　者：熊春[1] 黄丹[1] 马智[1] XIONG Chun;HUANG Dan;MA Zhi(Department of Oncology,the First Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou 545002,Guangxi,China)

机构地区：[1]广西科技大学第一附属医院肿瘤科,广西柳州545002

出　　处：《川北医学院学报》2024年第2期194-197,共4页Journal of North Sichuan Medical College

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研项目(Z20170100)。

摘　　要：目的:探究小剂量分次放疗增敏化疗在转移性结直肠癌(mCRC)治疗中的疗效及安全性。方法:根据治疗方式不同将72例一线化疗失败的mCRC患者分为观察组(n=37)和对照组(n=35)。对照组采用贝伐珠单抗^(+)化疗二线治疗。随访两年,比较两组患者的临床疗效、不良反应发生情况(白细胞、血小板)、治疗前后的血清肿瘤标志物水平[癌胚抗原(CEA)、糖类抗原199(CA199)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+))和生存情况[总生存期(OS)、无进展生存期(PFS)]。结果:观察组治疗后总有效率高于对照组(20.00%vs.43.24%,P<0.05);治疗后,两组CEA、CA199水平低于治疗前,且观察组低于对照组(P<0.05);两组CD3^(+)、CD4^(+)水平上升,且观察组高于对照组(P<0.05);CD8^(+)下降,且观察组低于对照组(P<0.05);两组白细胞下降、血小板减少等不良反应发生情况比较,差异无统计学意义(P>0.05);观察组两年OS、PFS分别为62.16%、40.54%,均高于对照组的37.14%、17.14%(P<0.05)。结论:小剂量分次放疗增敏化疗联合贝伐珠单抗^(+)化疗二线治疗mCRC具有较好的临床疗效,能改善患者的血清肿瘤标志物水平,提高其免疫功能,延长患者生存期,且具有一定安全性。Objective:To explore the efficacy and safety of low dose fractionated radiotherapy sensitization chemotherapy in the treatment of metastatic colorectal cancer(mCRC).Methods:72 mCRC patients who failed first-line chemotherapy were divided into observation group(n=37)and control group(n=35)according to different treatment methods.The control group was treated with bevacizumab^(+)second-line chemotherapy,and the observation group was treated with low-dose fractionated radiotherapy sensitization chemotherapy^(+)bevacizumab^(+)second-line chemotherapy.After two years of follow-up,the clinical efficacy,occurrence of adverse reactions[white blood cells,platelets],serum tumor marker levels before and after treatment[carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)],immune function(CD3^(+),CD4^(+),CD8^(+))and survival outcomes[overall survival(OS),progression-free survival(PFS)]were compared between two groups of patients.Results:The total effective rate of observation group was higher than that of control group(20.00%vs.43.24%,P<0.05).The CEA and CA199 levels in the two groups after treatment were lower than those before treatment,and the observation group was lower than the control group(P<0.05).After treatment,CD3^(+)and CD4^(+)levels in both groups increased,while CD8^(+)decreased,and CD3^(+)and CD4^(+)in the observation group increased faster than that in the control group,while CD8^(+)decreased faster(P<0.05).There was no significant difference in adverse reactions such as leukopenia and thrombocytopenia between the two groups(P>0.05).The 2-year OS and PFS of the observation group were 62.16%and 40.54%,respectively,which were higher than 37.14%and 17.14%of the control group(P<0.05).Conclusion:Low-dose fractionated radiotherapy sensitization chemotherapy combined with bevacizumab^(+)chemotherapy second-line treatment of mCRC has good clinical efficacy,can improve the level of serum tumor markers in patients,improve their immune function,prolong the survival time of patients,and has certain safety.

关 键 词：转移性结直肠癌 小剂量分次放疗 增敏化疗 贝伐珠单抗 化疗 

分 类 号：R735.34[医药卫生—肿瘤]