Evaluation value of serum lactate dehydrogenase level,neutrophil-lymphocyte ratio and plasma fibrinogen-prealbumin ratio on palliative chemotherapy effect and adverse reactions in patients with advanced colorectal cancer
Objective To analyze the evaluation value of serum lactate dehydrogenase(LDH)level,neutrophil-lymphocyte ratio(NLR)and plasma fibrinogen-prealbumin ratio(FPR)in palliative chemotherapy for patients with advanced colorectal cancer.Methods From March 2021 to March 2023,80 patients with advanced colorectal cancer in our hospital were selected,and all of them were treated with FOLFOXIRI(fluorouracil/calcium folinate,oxaliplatin and irinotecan)combined with cetuximab palliative chemotherapy.The effect of chemotherapy was evaluated after 2 cycles of chemotherapy,and the occurrence of adverse reactions during chemotherapy was recorded.The differences of LDH,NLR,FPR and clinical data between patients with different chemotherapy effects and patients with and without adverse reactions before chemotherapy were compared.Logistic regression model was used to summarize the related factors affecting the effect and adverse reactions of palliative chemotherapy.Results A All 80 patients completed 2 cycles of chemotherapy.After 2 cycles of chemotherapy,there were 0 case of CR,28 cases of PR,30 cases of SD and 22 cases of PD.The total effective rate was 35.00%(28/80)and the disease control rate was 72.50%(68/80).The main adverse reactions were grade Ⅰ-Ⅱ nausea,diarrhea and leukopenia,and grade Ⅲ-Ⅳ adverse reactions were rare,with the incidence of adverse reactions being 63.75%.Multivariate analysis showed that age≥60 years,poor differentiation,LDH≥245 U/L,NLR≥3.21,FPR≥0.10 were all independent risk factors affecting the short-term efficacy of palliative chemotherapy in patients with advanced colorectal cancer(P<0.05).Age≥60 years and FPR≥0.10 were independent risk factors for adverse reactions of palliative chemotherapy in patients with advanced colorectal cancer(P<0.05).Conclusion The effect of palliative chemotherapy in patients with advanced colorectal cancer is related to age,LDH,NLR and FPR,and its adverse reactions are related to age and FPR.It is expected to guide the prediction of curative effect and adverse reactions by improving clinical data collection and laboratory indicators before chemotherapy.
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