奥沙利铂联合卡培他滨新辅助化疗治疗局部进展期低位直肠癌的疗效及影响因素  

Efficacy ang influencing factors of oxaliplatin combined with capecitabine neoadjuvant chemotherapy in the treatment of locally advanced low rectal cancer

作　　者：孙伟 刘敬峰[1] 陈晨 杨磊 Sun Wei;Liu Jingfeng;Chen Chen;Yang Lei(Department of Medical Oncology,People's Hospital of Jieshou City,Jieshou 236500,China;Department of Radiation Oncology,Lu'an Hospital of Traditional Chinese Medicine,Lu'an 237000,China)

机构地区：[1]界首市人民医院肿瘤内科,安徽省236500 [2]六安市中医院放疗科,安徽省237000

出　　处：《中华消化病与影像杂志（电子版）》2024年第3期208-212,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的观察奥沙利铂联合卡培他滨(XELOX方案)新辅助化疗治疗局部进展期低位直肠癌的疗效,分析影响疗效的影响因素。方法采用实体瘤疗效评价新标准(RECIST 1.1)评估界首市人民医院2019年6月至2023年6月收治的113例局部进展期低位直肠癌患者接受XELOX方案新辅助化疗近期疗效,以完全缓解(CR)、部分缓解(PR)之和计算客观缓解率,比较客观缓解、非客观缓解患者新辅助化疗前后血清肿瘤标志物、免疫功能变化,并比较2组患者临床资料,使用Logistic多因素回归分析,归纳影响患者近期疗效的相关因素。结果113例患者化疗2周期后,CR 10例,PR 45例,SD 49例,PD 9例;客观缓解率为48.67%(55/113)。客观缓解组化疗2周期后CEA、CA125、CA199低于非客观缓解组(P<0.05)。客观缓解组化疗2周期后CD_(3)^(+)、CD_(4)^(+)高于非客观缓解组,其CD_(8)^(+)低于非客观缓解组(P<0.05)。多因素Logistic回归模型显示,年龄≥60岁、吸烟史是影响XELOX方案治疗局部进展期低位直肠癌疗效的独立风险因素,临床分期N0期、高分化为保护性因素(P<0.05)。结论XELOX方案能够有效降低局部进展期低位直肠癌患者肿瘤标志物水平、改善免疫功能,但其疗效受患者年龄、吸烟史、临床分期、肿瘤分化程度等多种因素影响。Objective To observe the efficacy of oxaliplatin combined with capecitabine(XELOX regimen)neoadjuvant chemotherapy in the treatment of locally advanced low rectal cancer,and analyze the influencing factors.Methods The short-term curative effect of XELOX neoadjuvant chemotherapy in 113 patients with locally advanced low rectal cancer treated in the People's Hospital of Jieshou City from June,2019 to June 2023 was evaluated by the new Response Evaluation Criteria in Solid Tumors(RECIST 1.1).The objective remission rate was calculated by the sum of complete remission(CR)and partial remission(PR).The changes of serum tumor markers and immune function of patients with objective remission and non-objective remission before and after neoadjuvant chemotherapy were compared,and the clinical features of the two groups were compared.Multivariate Logistic regression analysis was used to summarize the relevant factors affecting the short-term curative effect of patients.Results After two cycles of chemotherapy,there were 10 cases of CR,45 cases of PR,49 cases of SD and 9 cases of PD.The objective remission rate was 48.67%(55/113).CEA,CA125 and CA199 in objective remission group were lower than those in non-objective remission group after 2 cycles of chemotherapy(P<0.05).After 2 cycles of chemotherapy,CD_(3)^(+)and CD_(4)^(+)in objective remission group were higher than those in non-objective remission group,and CD_(8)^(+)was lower than that in non-objective remission group(P<0.05).Multivariate Logistic regression model showed that age≥60 years old and smoking history were independent risk factors affecting the curative effect of XELOX regimen for locally advanced low rectal cancer,while clinical stage N0 and high differentiation were protective factors(P<0.05).Conclusion XELOX regimen can effectively reduce the level of tumor markers and improve immune function in patients with locally advanced low rectal cancer,but its curative effect is affected by many factors such as patients'age,smoking history,clinical stage and tumor

关 键 词：奥沙利铂 卡培他滨 新辅助化疗 局部进展期 低位直肠癌 影响因素 

分 类 号：R735.37[医药卫生—肿瘤]