阿帕替尼联合卡培他滨+奥沙利铂方案对中晚期结直肠癌患者近期疗效及血管生成指标的影响  

Effect of apatinib combined with capecitabine and oxaliplatin regimen on shortterm efficacy and angiogenesis indicators in patients with advanced colorectal cancer

作　　者：郭琴琴 张静[2] 燕丽香[3] GUO Qinqin;ZHANG Jing;YAN Lixiang(Anning Care Center of Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101108,China;Department of Special Diagnosis and Geriatrics,Shanxi Cancer Hospital,Taiyuan 030013,China;Department of Oncology,Beijing Shijingshan Hospital,Beijing 100040,China)

机构地区：[1]首都医科大学附属北京潞河医院安宁疗护中心,北京101108 [2]山西省肿瘤医院特诊老年科,山西太原030013 [3]北京石景山医院肿瘤科,北京100040

出　　处：《药物评价研究》2024年第4期809-816,共8页Drug Evaluation Research

摘　　要：目的观察阿帕替尼联合卡培他滨+奥沙利铂(XELOX)化疗治疗中晚期结直肠癌患者的近期疗效。方法选取2019年6月—2023年3月北京石景山医院和山西省肿瘤医院收治的76例中晚期结直肠癌患者,按1∶1原则将患者随机分为对照组和试验组,每组各38例。对照组采用XELOX化疗方案,试验组在XELOX化疗基础上同时口服甲磺酸阿帕替尼片,每次850 mg,每天1次,餐后服用,每3周为1个疗程,连续治疗至疾病进展,或无法耐受。对比两组近期疗效,比较两组治疗前后血管生成指标、肿瘤标志物、炎症指标、免疫功能指标等,比较两组治疗期间不良反应发生情况。结果试验组在进行2个周期治疗后,近期疾病缓解率60.53%显著高于对照组的39.47%(P<0.05)。治疗前,两组血管内皮生长因子(VEGF)、血管生成素(Ang)-1、Ang-2及白细胞介素(IL)-8、肿瘤坏死因子(TNF)-α、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、CD3^(+)、CD3^(+)CD4^(+)、CD4^(+)/CD8^(+)、自然杀伤细胞(NK)等各项指标比较,差异均不显著(P>0.05)。治疗2个周期后,两组Ang-1、Ang-2、VEGF、IL-8水平均较本组治疗前显著降低(P<0.05),CEA、CA19-9、CA125水平均较本组治疗前显著降低(P<0.05),TNF-α及NLR、PLR均较本组治疗前显著降低(P<0.05)。治疗2个周期后,试验组的VEGF、Ang-1、Ang-2及IL-8水平均显著低于对照组(P<0.05);TNF-α、NLR、PLR水平均显著低于对照组(P<0.05);肿瘤标志物CEA、CA19-9、CA125水平显著低于对照组(P<0.05)。治疗2个周期后,对照组CD3^(+)、CD3^(+)CD4^(+)、CD4^(+)/CD8^(+)、NK细胞较治疗前无显著变化(P>0.05),而试验组各项免疫功能指标较治疗前有所改善(P<0.05),且试验组CD3^(+)、CD3^(+)CD4^(+)、CD4^(+)/CD8^(+)、NK细胞均高于对照组(P<0.05)。两组治疗期间的不良反应均可控,且3~4级不良反应发生率较低,两组骨�Objective To observe the short-term efficacy of apatinib combined with capecitabine and oxaliplatin(XELOX)chemotherapy in the treatment of patients with advanced colorectal cancer.Method 76 patients with advanced colorectal cancer admitted to Beijing Luhe Hospital affiliated with Capital Medical University from June 2019 to March 2023 were randomly dividedinto a control group and an experimental group based on a 1∶1 ratio,with 38 cases in each group.The control group received XELOX chemotherapy regimen,while the experimental group received concurrent oral administration of Apatinib Mesylate Tablets at a dose of 850 mg per dose,once a day,after meals,for a course of treatment every three weeks until disease progression or intolerance.The recent therapeutic effects of two groups was compared,the angiogenesis indicators,tumor markers,inflammation indicators,immune function indicators were compared,before and after treatment.The incidence of adverse reactions during the treatment period between the two groups was compared.Results After two cycles of treatment,the recent disease remission rate of the experimental group was 60.53%,which was significantly higher than that of the control group(39.47%,P<0.05).Before treatment,there were no significant differences in vascular endothelial growth factor(VEGF),angiopoietin(Ang)-1,Ang-2,interleukin(IL)-8,tumor necrosis factor(TNF)-α,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 125(CA125),CD3^(+),CD3^(+)CD4^(+),CD4^(+)/CD8^(+),natural killer cell(NK)and other indicators between the two groups(P>0.05).After two cycles of treatment,the levels of Ang-1,Ang-2,VEGF and IL-8 in the two groups were significantly lower than those before treatment(P<0.05),the levels of CEA,CA19-9 and CA125 were significantly lower than those before treatment(P<0.05),and TNF-α,NLR and PLR were significantly lower than those before treatment(P<0.05).After two cycles of treatment,the levels

关 键 词：阿帕替尼 XELOX化疗 卡培他滨 奥沙利铂 结直肠癌 血管生成 

分 类 号：R979.1[医药卫生—药品]