| 殷瑛.卡培他滨联合奥沙利铂治疗不同病理类型结直肠癌的疗效观察[J].安徽医药,2019,23(10):2078-2081. |
| 卡培他滨联合奥沙利铂治疗不同病理类型结直肠癌的疗效观察 |
| Therapeutic effect of capecitabine and oxaliplatin on different pathological types of colorectal cancer |
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| DOI：10.3969/j.issn.1009?6469.2019.10.044 |
| 中文关键词: 结直肠肿瘤 卡培他滨 奥沙利铂 存活率 干扰素 γ 转化生长因子 α |
| 英文关键词: Colorectal neoplasms Capecitabine Oxaliplatin Survival rate Interferon gamma Transforming growth factor alpla |
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| 中文摘要: |
| 目的探究卡培他滨和奥沙利铂联合应用对不同型别结直肠癌的治疗效果。方法选取 2011年 1月至 2013年 1月于无锡市第九人民医院术后接受治疗的 36例印戒细胞癌病人和 36例黏液腺癌病人，按照癌症类型分为黏液腺癌组和印戒细胞癌组。均给予两组病人卡培他滨与奥沙利铂联合药物治疗， 3周为 1个疗程，共 8个疗程。每个疗程前 2周病人连续口服卡培他滨，每日两次，早晚各 1 250 mg/m2停药 1周；每个疗程第 1天将奥沙利铂按 130 mg/m2剂量，溶入 300～500 mL葡萄糖溶液静脉滴定，每个疗程仅用药 1次。观察近，期治疗效果和治疗后不良反应的情况，记录治疗后病人干扰素 γ(IFN?γ)、血清转化生长因子 α(TGF?α)、 3种白细胞介素( IL?10、IL?4、IL?2)和胰岛素生长因子 Ⅱ(IGF?Ⅱ)的水平值，并观察药物治疗前后变化情况， 8个疗程后观察临床疗效，进行 5年随访并记录。结果治疗后，血清 IGF?Ⅱ、TGF?α、IL?10和 IL?4水平均有所下降，但是黏液腺癌组下降水平高于印戒细胞癌组，血清 IFN?γ和 IL?2均有所上升，但黏液腺癌组上升水平高于印戒细胞癌组，差异有统计学意义(P＜0.05)；两组临床疗效比较，黏液腺癌组有效率为 91.7%，印戒细胞癌组有效率为 69.4%，黏液腺癌组治疗效果明显高于印戒细胞癌组( χ2＝4.876，P＝0.032)。 5年内存活率比较，黏液腺癌组和印戒细胞癌组存活时间超过 1年的存活率分别为 91.7%和 66.7%，超过 3年的分别为 75.0%和 30.6%，超过 5年的分别为 33.3%和 5.6%，黏液腺癌组存活率明显比印戒细胞癌组高，以上 3组数据进行比较，均差异有统计学意义( P＜0.05)。结论卡培他滨联合奥沙利铂治疗结直肠癌，能提高体液免疫，遏制癌细胞增殖，治疗黏液腺癌的效果明显优于印戒细胞癌。 |
| 英文摘要: |
| Objective To explore the therapeutic effects of capecitabine and oxaliplatin on different types of colorectal cancer. Methods Thirty?six postoperative patients with signet ring cell carcinoma and 36 postoperative patients with mucinous adenocarci?noma who were treated at The Ninth People’s Hospital of Wuxi City from January 2011 to January 2013 were assigned into muci?nous adenocarcinoma group and signet ring cell carcinoma group according to the type of cancer.Both groups were given a combina?tion of capecitabine and oxaliplatin for a total of 8 courses with 3 weeks as a course of treatment.Two weeks before each course of treatment，patients were given oral capecitabine twice daily，1 250 mg/m2 in the morning and evening，and then the treatment dis? continued for 1 week.On the first day of each course of treatment，oxaliplatin was dosed at 130 mg/m2，which titrated intravenously in 300?500 mL glucose solution，only once per course of treatment.The recent treatment effect and adverse reactions after treatment were observed，and the levels of interferon gamma(IFN?γ)serum transforming growth factor alpha(TGF?α)，three interleukins(IL?10，IL?4，IL?2)andinsulingrowthfactorⅡ(IGF?Ⅱ)inp，atients after treatment were recorded.Changes were observed before and after drug treatment.The clinical efficacy was observed after 8 courses of treatment and followed up and recorded for 5 years. Results After treatment，serum IGF?II，TGF?α，IL?10 and IL?4 levels decreased，which were lower in mucinous adenocarcinoma group than in signet ring cell carcinoma group；serum IFN?γ and IL?2 levels increased，which were higher in the mucinous adeno? carcinoma group than in the signet ring cell carcinoma group，and the differences were statistically significant(P＜0.05).The clini? cal efficacies of the two groups were 91.7% in the mucinous adenocarcinoma group and 69.4% in the signet ring cell carcinomagroup.The treatment effect in the mucinous adenocarcinoma group was significantly better than that in the signet ring cell carcino?ma group(χ2＝4.876，P＝0.032).The 5?year survival rates were compared between the two groups.The survival rates over 1 year，3 years and 5 years in the mucinous adenocarcinoma group and the signet ring cell carcinoma group were 91.7% and 66.7%，75.0% and 30.6%，and 33.3% and 5.6%，respectively.The survival rate of mucinous adenocarcinoma group was significantly higher than that of signet ring cell carcinoma group.The differences were statistically significan(P＜0.05).Conclusions Capecitabine com?bined with oxaliplatin in the treatment of colorectal cancer can improve humoral immunity and suppress cancer cell proliferation. |
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