目的 探究瑞戈非尼联合XELOX化疗方案治疗结直肠癌疗效及对血管新生指标、肿瘤免疫逃逸的影响。方法 选取2018年1月—2022年1月泸州市人民医院收治的80例结直肠癌患者，随机分为对照组和治疗组，每组各40例。对照组采用XELOX方案治疗，第1天静脉滴注注射用奥沙利铂130 mg/m²；第1～14天，口服卡培他滨片1 000 mg/m²，2次/d；21 d为1个周期。治疗组在对照组基础上口服瑞戈非尼片，160 mg/次，1次/d，用药21 d停用7 d，28 d为1个周期。病情进展或无法耐受停止用药。观察两组患者疾病控制率，比较治疗前后两组患者血清癌胚抗原（CEA）、大肠特异性抗原-2（CCSA-2）、糖类抗原19-9（CA19-9）、血管内皮生长因子（VEGF）、转化生长因子-β（TGF-β）、程序性死亡分子-1（PD-1）、程序性死亡分子配体-1（PD-L1）水平，及生存质量。结果 治疗后，治疗组疾病控制率（77.50%）较对照组（55.00%）明显升高（P<0.05）。治疗后，两组CA19-9、CCSA-2、CEA、TGF-β、VEGF、PD-1和PD-L1水平较治疗前明显降低（P<0.05），且治疗组比对照组降低更明显（P<0.05）。治疗3个周期后，治疗组生存质量明显优于对照组（P<0.05）。结论 瑞戈非尼联合XELOX方案治疗结直肠癌效果显著，可有效抑制血管新生，改善肿瘤细胞免疫逃逸，从而使肿瘤标志物水平降低，提高生存质量。

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

四川省卫生健康委科研立项课题（20201375）