[1]王敬东,张庆尧.Mfolfox6方案联合西妥昔单抗和辛伐他汀治疗K-Ras突变结直肠癌疗效及对预后的影响[J].陕西医学杂志,2022,51(10):1290-1293.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.028]
 WANG Jingdong,ZHANG Qingyao.Efficacy and prognosis of Mfolfox6 regimen combined with cetuximab and simvastatin in treatment of K-Ras mutant colorectal cancer[J].,2022,51(10):1290-1293.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.028]
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Mfolfox6方案联合西妥昔单抗和辛伐他汀治疗K-Ras突变结直肠癌疗效及对预后的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年10期
页码:
1290-1293
栏目:
药物与临床
出版日期:
2022-10-05

文章信息/Info

Title:
Efficacy and prognosis of Mfolfox6 regimen combined with cetuximab and simvastatin in treatment of K-Ras mutant colorectal cancer
作者:
王敬东张庆尧
(大连大学附属新华医院,辽宁 大连116021)
Author(s):
WANG JingdongZHANG Qingyao
(Xinhua Hospital Affiliated to Dalian University,Dalian 116021,China)
关键词:
Mfolfox6方案 西妥昔单抗 辛伐他汀 K-Ras突变结直肠癌 预后
Keywords:
Mfolfox6 regimen Cetuximab Simvastatin K-Ras mutant colorectal cancer Prognosis
分类号:
R 735.37
DOI:
DOI:10.3969/j.issn.1000-7377.2022.10.028
文献标志码:
A
摘要:
目的:探究对K-Ras突变结直肠癌患者采用Mfolfox6方案联合西妥昔单抗和辛伐他汀进行治疗的临床疗效,并分析患者治疗后生存时长的相关危险因素。 方法:将128例K-Ras突变的结直肠癌患者按照随机数表法分为观察组和对照组(各64例)。对照组患者治疗方式为Mfolfox6方案联合西妥昔单抗,观察组在对照组基础上给予辛伐他汀治疗。①对两组患者临床疗效进行比较; ②记录并比较两组患者不良反应的发生情况; ③比较两组患者治疗后2年内的总体生存率; ④分析患者治疗后生存时长的相关危险因素。 结果:①与对照组患者相比,观察组患者完全缓解(CR)、病情稳定(SD)例数较多,病情进展(PR)、部分缓解(PD)例数较少,总体临床疗效显著提高,组间比较差异有统计学意义(均P<0.05); ②观察组患者不良反应发生率(25.00%)明显低于对照组(42.19%),组间比较差异有统计学意义(P<0.05); ③与对照组相比,观察组治疗后1年、治疗后2年生存患者均有明显升高,且组间比较差异有统计学意义(P<0.05); ④患者的平均生存时间与病理分级、腹膜转移以及治疗方案有显著相关性(均P<0.05),病理分级与腹膜转移是患者治疗后生存时间较短的危险因素。结论:采用Mfolfox6方案+西妥昔单抗+辛伐他汀治疗方案能够显著提高K-Ras突变的结直肠癌患者临床疗效,明显降低患者治疗过程中的不良反应发生率,治疗后患者生存率高,延长患者的生存时间。患者病理状况以及是否存在腹膜转移是影响患者预后的主要因素。
Abstract:
Objective:To explore the clinical efficacy of Mfolfox6 regimen combined with cetuximab and simvastatin in the treatment of K-Ras mutant colorectal cancer patients,and to analyze the related risk factors of the patients' survival time after treatment.Methods:A total of 128 patients with K-Ras-mutated colorectal cancer were randomly divided into observation group and control group according to the random number table method,64 cases in each.The patients in the control group were treated with Mfolfox6 regimen combined with cetuximab,and the patients in the observation group were treated with simvastatin on the basis of the control group.The clinical efficacy of the two groups was compared.The occurrence of adverse reactions in the two groups was recorded and compared,and the overall survival rates within 2 years after treatment were compared between the two groups.The risk factors related to the survival time of patients after treatment were analyzed.Results:Compared with the control group,the observation group had more cases of CR and SD,but fewer cases of PR and PD,and the overall clinical efficacy was significantly improved(all P<0.05).The incidence of adverse reactions in the observation group(25.00%)was significantly lower than that(42.19%)in the control group(P<0.05).Compared with the control group,the survival rate of the observation group 1 year and 2 years after treatment was significantly increased(all P<0.05).The average survival time of patients was significantly correlated with pathological grade,peritoneal metastasis and treatment plan(all P<0.05).Pathological grade and peritoneal metastasis were risk factors for shorter survival time after treatment.Conclusion:For colorectal cancer patients with K-Ras mutation,the Mfolfox6 regimen combined with cetuximab and simvastatin treatment regimen can significantly improve the clinical efficacy and significantly reduce the incidence of adverse reactions during treatment.The survival rate of patients after treatment is also significantly improved,prolonging the survival time of patients,and has good clinical application value.The pathological status of patients and the presence of peritoneal metastasis are also the main factors affecting the prognosis of patients.

参考文献/References:

[1] 姚 琳,杨 帅.硬膜外阻滞联合全身麻醉对老年结直肠癌患者围术期免疫功能及胃肠功能影响的临床研究[J].陕西医学杂志,2022,51(4):449-453.
[2] 赵英旋,白玉勤.结直肠癌患者肿瘤出芽情况与临床病理特征、程序性死亡受体1及程序性死亡配体1表达相关性研究[J].陕西医学杂志,2021,50(6):747-751.
[3] 陈益家,唐佳佳,刘世举.八珍散加减改善结直肠癌根治术后患者胃肠功能和免疫功能临床研究[J].陕西中医,2021,42(5):577-581.
[4] 肖正红,翟焕阁,王苏芳.贝伐珠单抗联合FOLFOX化疗方案治疗66例结直肠癌肝转移患者的临床疗效[J].医药论坛杂志,2019,40(7):144-146.
[5] 王 洁,张云清,赵 斌,等.K-ras诱导细胞衰老与胃癌及癌前病变关系研究[J].陕西医学杂志,2021,50(3):370-373.
[6] 张若荣.RAS 基因野生型晚期大肠癌分子靶向治疗现状及进展[J].贵州医药,2018,42(4):416-419.
[7] 毛 英,刘 黎,张 匠,等.辅助化疗XELOX方案与FOLFOX方案在Ⅱ-Ⅲ期结肠癌中的应用比较[J].实用医院临床杂志,2018,15(6):48-52.
[8] 张 雯.FOLFOXIRI联合贝伐珠单抗研究进展及其在结直肠癌肝转移治疗中的应用思考[J].肝癌电子杂志,2019,6(2):5-9.
[9] 蔡建强,蔡三军,秦新裕,等.结直肠癌肝转移诊断和综合治疗指南(V2016)[J].中华胃肠外科杂志,2016,19(7):721-730.
[10] 靳宏虎,赵长应,张 桢,等.两种实体瘤疗效评价标准对肝细胞癌患者系统化疗效果评价的比较[J].中华肝胆外科杂志,2019,25(6):411-414.
[11] 林增海,陆 军,王凯松.槲皮素对5-FU诱导的结直肠癌SW480细胞耐药及自噬调控机制研究[J].陕西中医,2021,42(10):1338-1343.
[12] 汪耔璇,李 烜.补中益气汤联合化疗治疗晚期结直肠癌临床研究[J].陕西中医,2020,41(10):1414-1417.
[13] 王建刚,张 帆,孔 娜,等.胎盘多肽注射液联合mFOLFOX6方案对结直肠癌患者术后血脂及不良反应的影响[J].药物评价研究,2018,41(8):1481-1485.
[14] 毛山山,程小珍,崔荣花,等.脾多肽注射液联合mFOLFOX6方案治疗晚期结肠癌的效果及对免疫功能的影响[J].中国医药导报,2018,15(20):91-95.
[15] 吴 夕,邓冰彬,白春梅,等.西妥昔单抗治疗 KRAS 或全RAS 野生型转移性结直肠癌的疗效及预后分析[J].中国医学科学院学报,2018,40(5):660-666.
[16] 吴军宜,陈桂生,韦 林.西妥昔单抗或贝伐单抗联合 FOLFOX4方案治疗野生型 KRAS 晚期直肠癌的临床疗效[J].药物评价研究,2019,42(4):693-696.
[17] 刘茂希,张毅勋,冯 毅,等.mFOLFOX6 方案化疗+西妥昔联合脾多肽治疗直肠癌肝转移患者的临床观察[J].实用医学杂志,2020,36(7):854-858.
[18] 俞 悦,张 雯,孙永琨,等.比较西妥昔单抗双周与每周方案联合FOLFOX/XELOX 一线治疗KRAS/RAS 野生型转移性结直肠癌的回顾性研究[J].中国肿瘤临床,2018,45(23):1210-1214.
[19] 陈雪岩.辛伐他汀逆转 KRAS 基因突变所致结肠癌细胞对西妥昔单抗的耐药研究[D].大连:大连医科大学,2017.
[20] 孙光源,史玉洁,李文贤,等.西妥昔单抗联合化疗治疗K-Ras野生型转移性结直肠癌的疗效及其影响因素分析[J].现代生物医学进展,2019,19(18):3563-3567.

备注/Memo

备注/Memo:
基金项目:吴阶平医学会基金资助项目(320.6750.17172)
更新日期/Last Update: 2022-10-07