Efficacy ang influencing factors of oxaliplatin combined with capecitabine neoadjuvant chemotherapy in the treatment of locally advanced low rectal cancer
Objective To observe the efficacy of oxaliplatin combined with capecitabine(XELOX regimen)neoadjuvant chemotherapy in the treatment of locally advanced low rectal cancer,and analyze the influencing factors.Methods The short-term curative effect of XELOX neoadjuvant chemotherapy in 113 patients with locally advanced low rectal cancer treated in the People's Hospital of Jieshou City from June,2019 to June 2023 was evaluated by the new Response Evaluation Criteria in Solid Tumors(RECIST 1.1).The objective remission rate was calculated by the sum of complete remission(CR)and partial remission(PR).The changes of serum tumor markers and immune function of patients with objective remission and non-objective remission before and after neoadjuvant chemotherapy were compared,and the clinical features of the two groups were compared.Multivariate Logistic regression analysis was used to summarize the relevant factors affecting the short-term curative effect of patients.Results After two cycles of chemotherapy,there were 10 cases of CR,45 cases of PR,49 cases of SD and 9 cases of PD.The objective remission rate was 48.67%(55/113).CEA,CA125 and CA199 in objective remission group were lower than those in non-objective remission group after 2 cycles of chemotherapy(P<0.05).After 2 cycles of chemotherapy,CD3+and CD4+in objective remission group were higher than those in non-objective remission group,and CD8+was lower than that in non-objective remission group(P<0.05).Multivariate Logistic regression model showed that age≥60 years old and smoking history were independent risk factors affecting the curative effect of XELOX regimen for locally advanced low rectal cancer,while clinical stage N0 and high differentiation were protective factors(P<0.05).Conclusion XELOX regimen can effectively reduce the level of tumor markers and improve immune function in patients with locally advanced low rectal cancer,but its curative effect is affected by many factors such as patients'age,smoking history,clinical stage and tumor differentiation degree.
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