Effect of apatinib combined with capecitabine and oxaliplatin regimen on short-term efficacy and angiogenesis indicators in patients with advanced colorectal cancer
Objective To observe the short-term efficacy of apatinib combined with capecitabine and oxaliplatin(XELOX)chemotherapy in the treatment of patients with advanced colorectal cancer.Method 76 patients with advanced colorectal cancer admitted to Beijing Luhe Hospital affiliated with Capital Medical University from June 2019 to March 2023 were randomly divided into a control group and an experimental group based on a 1∶1 ratio,with 38 cases in each group.The control group received XELOX chemotherapy regimen,while the experimental group received concurrent oral administration of Apatinib Mesylate Tablets at a dose of 850 mg per dose,once a day,after meals,for a course of treatment every three weeks until disease progression or intolerance.The recent therapeutic effects of two groups was compared,the angiogenesis indicators,tumor markers,inflammation indicators,immune function indicators were compared,before and after treatment.The incidence of adverse reactions during the treatment period between the two groups was compared.Results After two cycles of treatment,the recent disease remission rate of the experimental group was 60.53％,which was significantly higher than that of the control group(39.47％,P＜0.05).Before treatment,there were no significant differences in vascular endothelial growth factor(VEGF),angiopoietin(Ang)-1,Ang-2,interleukin(IL)-8,tumor necrosis factor(TNF)-α,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 125(CA125),CD3+,CD3+CD4+,CD4+/CD8+,natural killer cell(NK)and other indicators between the two groups(P＞0.05).After two cycles of treatment,the levels of Ang-l,Ang-2,VEGF and IL-8 in the two groups were significantly lower than those before treatment(P＜0.05),the levels of CEA,CA19-9 and CA125 were significantly lower than those before treatment(P＜0.05),and TNF-α,NLR and PLR were significantly lower than those before treatment(P＜0.05).After two cycles of treatment,the levels of VEGF,Ang-1,Ang-2 and IL-8 in the experimental group were significantly lower than those in the control group(P＜0.05),the levels of TNF-α,NLR and PLR were significantly lower than those in the control group(P＜0.05),the levels of tumor markers CEA,CA19-9 and CA125 were significantly lower than those in the control group(P＜0.05).After two cycles of treatment,the levels of CD3+,CD3+CD4+CD4+/CD8+,NK cells in the control group had no significant change compared with those before treatment(P＞0.05),while the immune function indexes in the experimental group were improved compared with those before treatment(P＜0.05),and the levels of CD3+CD3+CD4+,CD4+/CD8+,NK cells in the experimental group were higher than those in the control group(P＜0.05).The adverse reactions in the two groups during treatment were controllable,and the incidence of grade 3-4 adverse reactions was low.There was no significant difference in the incidence of bone marrow suppression,gastrointestinal reactions,liver and kidney dysfunction,hematological toxicity between the two groups(P＞0.05).Conclusion Apatinib combined with XELOX chemotherapy has a good short-term effect in the treatment of advanced colorectal cancer patients,and can reduce the expression of angiogenic factors,improve the immune function of patients to a certain extent,which is worthy of clinical attention.
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