目的 探究瑞戈非尼聯(lián)合XELOX化療方案治療結(jié)直腸癌療效及對血管新生指標(biāo)、腫瘤免疫逃逸的影響。方法 選取2018年1月—2022年1月瀘州市人民醫(yī)院收治的80例結(jié)直腸癌患者，隨機(jī)分為對照組和治療組，每組各40例。對照組采用XELOX方案治療，第1天靜脈滴注注射用奧沙利鉑130 mg/m²；第1～14天，口服卡培他濱片1 000 mg/m²，2次/d；21 d為1個(gè)周期。治療組在對照組基礎(chǔ)上口服瑞戈非尼片，160 mg/次，1次/d，用藥21 d停用7 d，28 d為1個(gè)周期。病情進(jìn)展或無法耐受停止用藥。觀察兩組患者疾病控制率，比較治療前后兩組患者血清癌胚抗原（CEA）、大腸特異性抗原-2（CCSA-2）、糖類抗原19-9（CA19-9）、血管內(nèi)皮生長因子（VEGF）、轉(zhuǎn)化生長因子-β（TGF-β）、程序性死亡分子-1（PD-1）、程序性死亡分子配體-1（PD-L1）水平，及生存質(zhì)量。結(jié)果 治療后，治療組疾病控制率（77.50%）較對照組（55.00%）明顯升高（P<0.05）。治療后，兩組CA19-9、CCSA-2、CEA、TGF-β、VEGF、PD-1和PD-L1水平較治療前明顯降低（P<0.05），且治療組比對照組降低更明顯（P<0.05）。治療3個(gè)周期后，治療組生存質(zhì)量明顯優(yōu)于對照組（P<0.05）。結(jié)論 瑞戈非尼聯(lián)合XELOX方案治療結(jié)直腸癌效果顯著，可有效抑制血管新生，改善腫瘤細(xì)胞免疫逃逸，從而使腫瘤標(biāo)志物水平降低，提高生存質(zhì)量。

Objective To explore the efficacy of rigofenib combined with XELOX regimen in treatment of colorectal cancer and its effect on angiogenesis and tumor immune escape. Methods Patients (80 cases) with colorectal cancer in Luzhou People's Hospital from January 2018 to January 2022 were randomly divided into control and treatment group, and each group had 40 cases. Patients in the control group were given XELOX regimen, including intravenous infusion 130 mg/m² of Oxaliplatin for injection for the 1st day, and po 1 000 mg/m² of Capecitabine Tablets from day 1 to day 14, twice daily, and 21 days was a cycle. Patients in the treatment group were po administered with Regorafenib Tablets on the basis of the control group, 160 mg/time, once daily, 7 days of withdrawal after 21 days of medication, and 28 days as a cycle. Progression or inability to tolerate stop taking the medication. After treatment, the disease control rate was evaluated, and the levels of CA19-9, CCSA-2, CEA, TGF-β, VEGF, PD-1 and PD-L1, and quality of life in two groups before and after treatment were compared. Results After treatment, the disease control rate in the treatment group (77.50%) was significantly higher than that in the control group (55.00%) (P < 0.05). After treatment, the levels of serum CA19-9, CCSA-2, CEA, TGF-β, VEGF, PD-1 and PD-L1 in two groups were significantly lower than those before treatment (P < 0.05), and the levels in the treatment group were significantly lower than those in the control group (P < 0.05). After 3 cycles of treatment, the quality of life in the treatment group was significantly better than that in the control group (P < 0.05). Conclusions Rigofenib combined with XELOX regimen is effective in the treatment of colorectal cancer, which can effectively inhibit angiogenesis and improve tumor cell immune escape, so as to reduce the level of tumor markers and improve the quality of life.

R979.1

四川省衛(wèi)生健康委科研立項(xiàng)課題（20201375）