2020 年第 2 期 第 15 卷

替吉奥联合奥沙利铂治疗老年晚期结肠癌的效果及对血清学指标的影响

Effect of tegafur/gimeracil/oteracil potassium plus oxaliplatin on advanced colon cancer and the influence on serum markers in elderly patients

作者：王云涛熊伟杰徐毅何朗

英文作者：

单位：成都市第五人民医院肿瘤科611130

英文单位：

关键词：晚期结肠癌；替吉奥；奥沙利铂；卡培他滨；血清学指标；免疫功能

英文关键词：

• 摘要：

• 【摘要】目的    探讨替吉奥联合奥沙利铂治疗老年晚期结肠癌患者的临床效果，并观察其对患者血清学指标的影响。方法    选取2015年1月至2016年6月成都市第五人民医院晚期结肠癌患者100例，按照随机数字表法随机分为对照组和观察组，各50例。对照组患者给予卡培他滨联合奥沙利铂化疗；观察组患者给予替吉奥联合奥沙利铂化疗。分别于治疗前及治疗4个周期后检测患者血清肿瘤标志物水平，包括甲胎蛋白、癌胚抗原、糖类抗原19-9(CA19-9)和细胞质胸苷激酶1(TK1)，同时检测血清肿瘤坏死因子α（TNF-α）、白细胞介素2（IL-2）和γ-干扰素（INF-γ）水平。评价2组临床疗效，记录疾病进展时间和1年生存率，观察和记录治疗期间的不良反应。结果    2组治疗后甲胎蛋白、癌胚抗原、CA19-9、TK1水平均较治疗前明显下降，且观察组明显低于对照组［（5.2±1.2）μg/L比（8.8±2.4）μg/L、（13.6±1.9）μg/L比（19.9±3.2）μg/L、（127±24）kU/L比（158±31）kU/L、（1.1±0.4）pmol/L比（2.1±0.5）pmol/L］（均P＜0.05）。2组治疗后血清TNF-α、IL-2、INF-γ水平均明显高于治疗前，且观察组明显高于对照组［（67±5）ng/L比（59±5）ng/L、（73±7）ng/L比（66±6）ng/L、（26±5）ng/L比（18±4）ng/L］（均P＜0.05）。观察组治疗临床缓解率明显高于对照组［76.0%（38/50）比34.0%（17/50）］（P＜0.001）。2组无进展生存时间、1年生存率和不良反应发生率比较，差异均无统计学意义（均P＞0.05）。结论    采用替吉奥联合奥沙利铂治疗老年晚期结肠癌效果明显，有利于提高患者免疫功能，改善血清肿瘤标志物，提高治疗效果，且不会增加不良反应。

• 【Abstract】Objective    To observe the clinical effect of tegafur/gimeracil/oteracil potassium plus oxaliplatin on advanced colon cancer and the influence on serum markers in elderly patients. Methods    A total of 100 elderly patients with advanced colon cancer treated in Chengdu Fifth People′s Hospital from January 2015 to June 2016 were randomly divided into control group and observation group, with 50 cases in each group. The control group had capecitabine plus oxaliplatin chemotherapy. The observation group had tegafur/gimeracil/oteracil potassium plus oxaliplatin chemotherapy. Serum tumor markers including α-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9(CA19-9) and cytoplasmic thymidine kinase-1(TK1), inflammatory factors including necrosis factor-α(TNF-α), interleukin-2 (IL-2) and γ-interferon(INF-γ) were detected before and after 4 cycles of treatment. Clinical efficacy and adverse reactions during treatment were observed. Progression-free survival time and the 1-year survival rate were recorded. Results    After treatment, levels of α-fetoprotein, carcinoembryonic antigen, CA19-9 and TK1 significantly decreased and they were lower in observation than those in control group［（5.2±1.2）μg/L vs （8.8±2.4）μg/L, （13.6±1.9）μg/L vs （19.9±3.2）μg/L, （127±24）kU/L vs （158±31）kU/L, （1.1±0.4）pmol/L vs （2.1±0.5）pmol/L］; levels of TNF-α, IL-2 and INF-γ significantly increased and they were higher in observation than those in control group［（67±5）ng/L vs （59±5）ng/L, （73±7）ng/L vs （66±6）ng/L, （26±5）ng/L vs （18±4）ng/L］（all P＜0.05）. Clinical remission rate in observation group was significantly higher than that in control group［76.0%（38/50） vs 34.0%（17/50）］（P＜0.001）. There were no significant differences in progression-free survival time, 1-year survival rate and adverse reaction rate between groups（all P＞0.05）. Conclusion    Tegafur/gimeracil/oteracil potassium combined with oxaliplatin treating advanced colon cancer in the elderly can effectively improve immune function, serum tumor markers and the therapeutic response without increasing adverse reactions.