摘要
目的探讨信迪利单抗联合XELIRI方案治疗结直肠癌的疗效,并分析预后影响因素。方法选取2019年1月至2020年12月在浙江省丽水市人民医院就诊的直肠癌患者82例,按治疗方法分为对照组(41例,XELIRI方案治疗)和研究组(41例,信迪利单抗联合XELIRI方案治疗),比较2组治疗疗效和药物不良反应,随访3年,分析预后不良的影响因素。结果与对照组比较,研究组客观缓解率(ORR)(22%与20%)、疾病控制率(DCR)(73%与63%)更高,但差异无统计学意义(P>0.05)。与对照组比较,研究组恶心呕吐、腹泻、乏力、丙氨酸转氨酶升高、血红蛋白减低、血小板减低、中性粒细胞减低发生率差异无统计学意义(P>0.05),研究组皮疹、蛋白尿、甲状腺功能减退发生更高(P<0.05)。随访3年,研究组预后不良9例,对照组预后不良22例,研究组预后不良发生率低于对照组(P<0.05)。经单因素分析,与预后良好组比较,预后不良组卡氏功能状态量表(KPS)评分<70、淋巴结转移、治疗方法差异有统计学意义(P<0.05),其余因素差异无统计学意义(P>0.05)。经Cox回归分析,KPS评分≥70分是预后的保护因素(P<0.05),淋巴结转移、XELIRI方案是预后的危险因素(P<0.05)。结论信迪利单抗联合XELIRI方案治疗结直肠癌存在潜在获益,药物不良反应总体耐受,其安全性在可控范围,结直肠癌患者预后和KPS评分、淋巴结转移、治疗方法有关。
Objective To explore the efficacy of Xindilizumab combined with XELIRI regimen in the treatment of colorectal cancer and analyze prognostic factors.Methods From January 2019 to December 2020,a total of 82 patients with colorectal cancer were selected and divided into the control group(41 cases,treated with XELIRI regimen)and the study group(41 cases,treated with Xindilizumab combined with XELIRI regimen)by treatment.The therapeutic efficacy and adverse drug reactions of the two groups were compared.The patients were followed up for 3 year to analyze the influencing factors of poor prognosis.Results Compared with the control group,the study group had higher ORR(22%vs 20%)and DCR(73%vs 63%),but the difference was not statisti-cally significant(P>0.05).Compared with the control group,the incidences of nausea,vomiting,di-arrhea,fatigue,elevated transaminases,decreased hemoglobin,thrombocytopenia,and decreased neutropenia in the study group were not statistically significant(P>0.05),while the incidence of rash,proteinuria,and hypothy-roidism was higher in the study group(P<0.05).After a 3-year follow-up,there were 9 cases of poor prognosis in the study group and 22 cases in the control group(P<0.05).Univariate analysis showed that compared with the good prognosis group,the KPS score<70,lymph node metastasis,and treatment methods in the poor prognosis group were statistically significance(P<0.05),while the other factors were not statistically significance(P>0.05).According to Cox analysis of survival function,KPS score≥70 was a protective factor for poor prognosis(P<0.05),while lymph node metas-tasis and XELIRI regimen were risk factors for poor prognosis(P<0.05).Conclusion There is potential benefits from the combination of Xindilizumab and XELIRI regimen in the treatment of colorectal cancer,with overall tol-erable drug adverse reactions and controllable safety.The prognosis of colorectal cancer patients is related to KPS score,lymph node metastasis,and treatment methods.
作者
叶小荣
程涛
易弼顺
Ye Xiaorong;Cheng Tao;Yi Bishun(Department of Anoretal Surgery,Lishui People's Hospital,Lishui,Zhejiang 323000,China)
出处
《中国药物与临床》
CAS
2024年第16期1068-1072,共5页
Chinese Remedies & Clinics
