Comparative effects of oxaliplatin-based versus irinotecan-based regimens combined with capecitabine and bevacizumab in patients with colorectal cancer and liver metastases

奥沙利铂方案联合卡培他滨和贝伐单抗与伊立替康方案联合卡培他滨和贝伐单抗治疗结直肠癌肝转移患者的疗效比较

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Abstract

OBJECTIVE: To evaluate and compare the efficacy of oxaliplatin-based and irinotecan-based chemotherapy regimens, both combined with capecitabine and bevacizumab, in patients with colorectal cancer and liver metastases. METHODS: A retrospective analysis was conducted on 276 patients from Shanxi Province Cancer Hospital. Patients were divided into two groups (n = 138 each) based on treatment regimens. The control group received irinotecan hydrochloride, capecitabine, and bevacizumab, while the research group received oxaliplatin, capecitabine, and bevacizumab. Outcomes compared included overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS), serum vascular endothelial growth factor (VEGF), carbohydrate antigen 19-9 (CA19-9), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP), immunoglobulin levels (IgM, IgG), quality of life (QoL), pain scores (VAS), and adverse reactions. RESULTS: The research group showed significantly higher ORR (21.74%) and DCR (63.77%) than the control group (12.32% and 50.00%, respectively; both P < 0.05). One-year PFS, and OS were all significantly improved in the research group (both P < 0.05). Post-treatment, VEGF, CA19-9, LDH, and ALP levels decreased significantly in both groups, with greater reductions in the research group (all P < 0.05). The research group also reported lower VAS pain scores, better QoL improvements, higher IgM and IgG levels, and a lower incidence of adverse reactions (all P < 0.05). CONCLUSION: The oxaliplatin-based regimen significantly improves tumor control, biomarker profiles, survival, and patient well-being, with fewer adverse effects, supporting its clinical applicability.

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