首页|胸腺肽α1联合XELOX方案治疗结直肠癌术患者的临床研究

胸腺肽α1联合XELOX方案治疗结直肠癌术患者的临床研究

扫码查看
目的 观察胸腺肽α1注射剂联合卡培他滨和奥沙利铂(XELOX)方案对结直肠癌术患者循环肿瘤细胞(CTC)和血清癌胚抗原(CEA)、血清糖类抗原19-9(CA19-9)、CA125水平的影响.方法 将接受腹腔镜结直肠癌根治手术患者按队列法分为对照组和试验组.对照组予以辅助化疗XELOX方案,第1天给予135 mg·m-2奥沙利铂,静脉滴注3 h,1 000 mg·m-2卡培他滨片,bid,口服,连用2周、停用1周;试验组在对照组治疗的基础上,加用胸腺肽α1每次1.6 mg,qod,皮下注射.2组患者均治疗6个疗程,每个疗程3周.比较2组患者的CTC计数、血清肿瘤标志物、外周血T淋巴细胞亚群、血清炎症因子、生存质量、安全性、术后2年无进展生存率和总生存率,以及安全性.结果 试验组入组56例、对照组入组50例.试验组和对照组的术后2年无进展生存率分别为87.50%(49例/56例)和70.00%(35例/50例),在统计学上差异有统计学意义(P<0.05).治疗后,试验组和对照组的CTC计数分别为(1.21±0.39)和(1.52±0.46)个,血清 CEA 水平分别为(18.52±4.17)和(23.26±4.84)μg·L-1,CA19-9 水平分别为(63.94±10.22)和(69.73±12.35)U·L-1,CA125 水平分别为(40.66±9.29)和(46.79±10.24)U·L-1,外周血 CD4+/CD8+比值分别为1.38±0.18和1.24±0.16,血清白细胞介素-6水平分别为(32.04±5.57)和(37.26±6.18)ng·L-1,肿瘤坏死因子-α水平分别为(43.96±4.83)和(51.83±5.97)ng·L-1,Karnofsky 功能状态评分分别为(86.77±6.91)和(82.23±5.32)分,癌症患者生活质量核心量表评分分别为(69.12±9.76)和(75.06±9.84)分,在统计学上差异均有统计学意义(均P<0.05).治疗期间,试验组和对照组的中性粒细胞减少率分别为48.21%和76.00%,肝功能异常率分别为10.71%和40.00%,在统计学上差异均有统计学意义(均P<0.05).结论 胸腺肽α1注射剂联合XELOX方案辅助化疗可有效降低结直肠癌术后患者血清CEA、CA19-9、CA125水平,可改善患者细胞免疫功能,提高生存质量.
Clinical trial of thymosin α1 combined with XELOX regimen in the treatment of patients with colorectal cancer surgery
Objective To observe the influence of thymosin α1 injection combined with capecitabine and oxaliplatin(XELOX)regimen on circulating tumor cell(CTC)and serum carcinoembryonic antigen(CEA),serum carbohydrate antigen 19-9(CA19-9)and CA125 levels in patients with colorectal cancer surgery.Methods Patients who received laparoscopic radical resection of colorectal cancer were divided into control group and treatment group by adopting cohort method.The control group was treated with XELOX regimen adjuvant chemotherapy;and on the 1st day,135 mg·m-2of oxaliplatin was intravenously dripped for 3 h;and capecitabine tablets were taken orally at 1 000 mg·m-2 twice a day for 2 weeks and discontinued for 1 week.On the basis of the treatment in the control group,the treatment group was added with subcutaneous injection of 1.6 mg of thymosin α1 once a day.Both groups were treated for 6 courses with 3 weeks as a course of treatment.CTC count,serum tumor markers,peripheral blood T lymphocyte subsets,serum inflammatory factors,quality of life,safety and progression-free survival rate and overall survival rate at 2 years after surgery were compared between groups.Results Finally,56 cases in treatment group and 50 cases in control group were included.The progression-free survival rates in treatment group and control group at 2 years after surgery were 87.50%(49 cases/56 cases)and 70.00%(35 cases/50 cases),respectively(P<0.05).After treatment,the CTC counts in treatment group and control group were 1.21±0.39 and 1.52±0.46;serum CEA levels were(18.52±4.17)and(23.26±4.84)μg·L-1;the CA19-9 levels were(63.94±10.22)and(69.73±12.35)U·L-1;the CA125 level were(40.66±9.29)and(46.79±10.24)U·L-1;the peripheral blood CD4+/CD8+ratios were(1.38±0.18)and(1.24±0.16);serum interleukin-6(IL-6)levels were(32.04±5.57)and(37.26±6.18)ng·L-1;tumor necrosis factor-α(TNF-α)levels were(43.96±4.83)and(51.83±5.97)ng·L-1;the Karnofsky performance status(KPS)scores were(86.77±6.91)and(82.23±5.32)points;the cancer quality of life core 30(QLQ-C30)scores were(69.12±9.76)and(75.06±9.84)points(all P<0.05).During treatment,the neutropenia rates in treatment group and control group were 48.21%and 76.00%,and abnormal rates of liver function were 10.71%and 40.00%,respectively(all P<0.05).Conclusion Thymosin α1 injection combined with XELOX regimen adjuvant chemotherapy after colorectal cancer surgery can effectively reduce the levels of serum CEA,CA19-9 and CA125,and can improve the cellular immune function and enhance the quality of life.

thymosin α1 injectioncolorectal cancercirculating tumor cellcarcinoembryonic antigenserum carbohydrate antigen 19-9serum carbohydrate antigen 125

任晓东、胡震、李超亿、李耀平

展开 >

山西省人民医院结直肠肛门外科,山西太原 030000

胸腺肽α1注射剂 结直肠癌 循环肿瘤细胞 癌胚抗原 血清糖类抗原19-9 血清糖类抗原125

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(19)