| Objective:By comparing the effects of sunitinib and recombinant human interleukin-2 in post-operative patients with locally progressive renal cancer,we observed the changes in serum carcinoma-embryonic antigen(CEA),ferritin(FER),β2-microglobulin(β2-MG)and other tumor marker levels,immune indicators T lymphocyte CD4~+T,CD8~+T,CD4~+T/CD8~+T levels,changes in renal function indicators,and the impact of both on survival and complications,to comprehensively assess the reliability and safety of sunitinib in patients with locally progressive renal cancer after surgery.Methods:Ninety-two postoperative patients with locally progressive renal cancer who met the study inclusion criteria admitted to Puyang People’s Hospital from January 2018 to January 2021 were used as the subjects of this study,and their clinical data were retrospectively analyzed.All patients had undergone laparoscopic radical kidney cancer surgery and voluntarily chose whether to have adjuvant treatment with sunitinib or interleukin-2 after surgery.Statistical data were collected and divided into two groups according to the postoperative adjuvant treatment modality:among them,the observation group was those who applied sunitinib postoperatively and the control group was those who applied recombinant human interleukin-2 postoperatively.The treatment effects,changes in the levels of CEA,NSE,pro-GRP,VEGF,β2-MG,FER,and immune indexes CD4~+T,CD8~+T,CD4~+T/CD8~+T,changes in the levels of renal function indexes BUN and SCr,and the occurrence of complications were compared between the two groups.Among them,the count data were expressed as[cases(%)],and theχ~2test was used to verify whether the difference between the two groups of general data groups was significant,and the rank sum test was used in the validity analysis,and the rank sum test was applied when the measurement data did not conform to the normal distribution.Tumor markers and indicators of immune function,renal function,and QLQ-C30quality of life scores were subject to normal distribution and expressed as mean±standard deviation(x±s).t-test for paired design data was applied to compare the efficacy of the same group before and after treatment;t-test for independent samples was applied to compare the efficacy of the two groups before and after treatment.Two independent samples t-test was used when the variance was the same,and two independent samples corrected t-test was used when the variance was not the same.The statistical results were tested by two-sided test with a level of 0.05,and P<0.05 indicated that the difference was statistically significant.Results:1.Clinical efficacy:43 cases(92.48%)of relapse-free survival,relapse-free survival(15.62±3.25) months and disease-free survival(18.62±3.25)months were observed in the observation group.The control group had 34 cases(73.91%)of recurrence-free survival,recurrence-free survival(10.82±2.14)months,and disease-free survival(13.82±2.14)months.The recurrence-free survival rate,recurrence-free survival and disease-free survival were higher in the observation group than in the control group,and the difference between the groups was significant(P<0.05).2.Tumor marker levels:there was no statistically significant difference in the levels of CEA,NSE,pro-GRP,VEGF,β2-MG and FER between the two groups before treatment(P>0.05);after treatment,the levels of CEA,NSE,pro-GRP,VEGF,β2-MG and FER in both groups were significantly lower compared with those before treatment(P<0.05);compared with the control group,the levels of CEA,NSE,pro-GRP,VEGF,β2-MG and FER in the observation group were significantly lower than those in the control group.Compared with the control group,the levels of CEA,NSE,pro-GRP,VEGF,β2-MG and FER in the observation group decreased more significantly,and the difference between the groups was significant(P<0.05).3.Immune index T lymphocyte levels:before treatment,there was no statistically significant difference between the levels of T lymphocyte subsets CD4~+T,CD8~+T and CD4~+T/CD8~+T in the two groups(P>0.05);after treatment,the levels of T lymphocyte subsets CD4~+T,CD8~+T and CD4~+T/CD8~+T were significantly higher in both groups compared with those before treatment(P<0.05);compared with Compared with the control group,the T lymphocyte subsets CD4~+T,CD8~+T,CD4~+T/CD8~+T levels in the observation group increased more significantly,and the difference between the groups was significant(P<0.05).4.Renal function indexes:before treatment,there was no statistically significant difference between the two groups in the levels of the renal function indexes Scr and BUN(P>0.05);after treatment,the levels of the renal function indexes Scr and BUN in the two groups were significantly reduced compared with those before treatment(P<0.05);and compared with the control group,the levels of the renal function indexes Scr and BUN in the observation group were reduced more significantly,and the difference between the groups was significant(P<0.05).5.Complications:13 patients in the observation group had complications during the treatment period,with a total incidence of 28.26%;23 patients in the control group had complications during the treatment period,with a total incidence of 50.0%.Compared with the control group,the incidence of complications was significantly lower in the observation group,and the difference between the groups was significant(P<0.05).6.Survival quality scores:there was no significant difference in the scores of social function,role function,psychological function and somatic function and cognitive function between the two groups before treatment(P>0.05);compared with the pre-treatment group,the scores of social function,role function,psychological function and somatic function and cognitive function in both groups increased to different degrees after treatment(P<0.05);and compared with the control group,the observation group had significantly higher scores in the above social function.7.In terms of survival rate,the 1-year survival rate of the observation group was 89.13%and the2-year survival rate was 84.78%;the 1-year survival rate of the control group was 67.39%and the 2-year survival rate was 58.70%;the 1-year and 2-year survival rates of the observation group were much higher than those of the control group,and the differences between the groups were more significant(P<0.05).The 1-year and 2-year survival rates of the observation group were much higher than those of the control group,with significant differences between groups(P<0.05).Conclusion:In conclusion,in this experimental study,the application of sunitinib after laparoscopic radical nephrectomy to adjuvantly treat patients with locally progressive renal cancer was significantly beneficial.Compared with the postoperative application of recombinant human interleukin-2,sunitinib could reduce the patients’tumor marker levels to a certain extent,improve the patients’anti-tumor immunosuppressive ability,have less impact on renal function,prolong their postoperative disease-free survival and recurrence-free survival,and overall,serious adverse reactions caused by sunitinib were relatively rare,which is very important to improve the patients’prognosis and survival quality and is worthy of further clinical research and promotion. |
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