沙利度胺联合FOLFOX6方案治疗结直肠癌术后肝转移患者疗效及其对生存率的影响  

Efficacy of thalidomide combined with FOLFOX6 regimen in the treatment of postoperative liver metastasis from colorectal cancer and its impact on survival rate

作　　者：李佳慧 胡洁 林武华 袁海汀 樊婷 Li Jiahui;Hu Jie;Lin Wuhua;Yuan Haiting;Fan Ting(Department of Oncology,Sichuan Armed Police Force Hospital,Sichuan Province,Leshan 614000,China)

机构地区：[1]武警四川省总队医院肿瘤科,四川乐山614000

出　　处：《疑难病杂志》2024年第11期1308-1312,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：四川省卫生健康委员会科研课题项目(21PJ133)。

摘　　要：目的探讨沙利度胺联合FOLFOX6方案对结直肠癌术后肝转移治疗的效果,以及对患者肿瘤标志物、生存率的影响。方法选择2021年1月—2023年1月武警四川省总队医院肿瘤科收治的结直肠癌术后肝转移患者130例为研究对象,利用随机数字表法分为单一组65例与联合组65例。单一组采用FOLFOX6方案,联合组采用沙利度胺联合FOLFOX6方案。治疗4个周期后,比较2组临床疗效;治疗前后2组血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原199(CA199)]、炎性反应指标[白介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)与趋化因子受体4(CXCR4)]、体力状况、生存情况;记录并比较2组治疗期间不良反应发生情况。结果联合组总有效率高于单一组(52.31%vs.33.85%,χ^(2)/P=4.517/0.034)。治疗4个周期后,2组血清CEA、CA199均低于治疗前,且联合组CEA、CA199低于单一组(t/P=30.898/<0.001、17.832/<0.001);2组血清IL-4、TNF-α、CXCR4均下降,且联合组低于单一组(t/P=11.080/<0.001、12.162/<0.001、7.533/<0.001);2组KPS评分均上升,且联合组高于单一组(t/P=4.515/<0.001);联合组12个月生存率高于单一组(50.77%vs.30.77%,χ^(2)=5.383,P=0.020);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论结直肠癌术后肝转移患者采用沙利度胺联合FOLFOX6方案治疗,可有效延长生存时间,减少炎性反应,有一定临床应用价值。Objective To investigate the effect of thalidomide combined with FOLFOX6 on postoperative liver metastasis of colorectal cancer,tumor markers and survival rate.Methods A total of 130 patients with postoperative liver metastasis of colorectal cancer admitted to the First General Surgery Department of Sichuan Armed Police Corps Hospital from January 2021 to January 2023 were selected as the study objects,and were divided into a single group(65 cases)and a combined group(65 cases)by random number table method.The single group was treated with FOLFOX6 regimen and the combined group was treated with thalidomide combined with FOLFOX6 regimen.The clinical effect was compared between the two groups after treatment.Tumor markers[serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)],inflammatory response indicators[interleukin-4(IL-4),tumor necrosis factor-α(TNF-α)and chemokine receptor 4(CXCR4)],physical status and survival of 2 groups before and after treatment;the adverse reactions were recorded and compared between the two groups during treatment.Results The total effective rate of the combined group was higher than that of the single group(52.31%vs.33.85%,χ^(2)/P=4.517/0.034).After 4 cycles of treatment,CEA and CA199 in 2 groups were lower than before treatment,and CEA and CA199 in combination group were lower than those in single group(t/P=30.898/0.001,17.832/0.001);IL-4,TNF-αand CXCR4 decreased in 2 groups,and the combined group was lower than the single group(t/P=11.080/0.001,12.162/0.001,7.533/0.001);KPS scores increased in both groups,and the combined group was higher than the single group(t/P=4.515/0.001);The 12-month survival rate of the combined group was higher than that of the single group(50.77%vs.30.77%,χ2=5.383,P=0.020);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of postoperative liver metastases of colorectal cancer can effectively prolong the survival time and reduce the inflammatory response,the ef

关 键 词：结直肠癌 肝转移 术后 FOLFOX6方案 沙利度胺 炎性因子 疗效 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]