目的：探讨脾多肽联合FOLFOX4 或XELOX 方案用于Ⅲ/Ⅳ期结肠癌患者术后治疗的疗效及安全性。方法：回顾性 收集选择2017 年1 月至2020 年6 月期间在广东省惠州市第六人民医院接受晚期结肠癌根治术的患者160 例临床资料。将患者分 为脾多肽注射液、奥沙利铂、亚叶酸钙联合氟尿嘧啶组[脾多肽+FOLFOX4 组（脾F 组），n=80]与脾多肽注射液、奥沙利铂联合卡培 他滨组[脾多肽+XELOX 组（脾X 组），n=80]，两组患者均于手术后8 周开始进行6 个疗程的治疗，治疗结束1 个月后对两组患者的 临床疗效、免疫水平、营养状况、生存质量及不良反应等方面进行为期2 年的随访观察。结果:与脾F 组相比，脾X 组患者的ORR 和DCR 均显著提高（均P<0.05）；CD3+ T、CD4+ T、NK 细胞百分率、EORTC QLQ-C30 评分和PNI 水平均显著升高（均P<0.05），NLR、LMR、CA125、CA199、CEA均显著下降（均P<0.05）。脾X 组患者白细胞或粒细胞减少、神经毒性、口腔黏膜炎和手足综合征等 毒性作用和不良反应发生率均明显下降（均P<0.05）。两组患者2 年PFS 和OS 无明显差异（均P>0.05）。结论: 在Ⅲ/Ⅳ期结肠癌术 后患者的治疗中，脾多肽注射液联合XELOX方案比联合FOLFOX4方案在改善不良反应发生率和生活质量方面具有明显优势。

Objective: To examine the efficacy and safety of lienal polypeptide injection combined with FOLFOX4 or XELOX in the treatment of stage Ⅲ/Ⅳ colon cancer. Methods: One hundred and sixty patients who underwent a curative resection of colon cancer in the Sixth People's Hospital of Huizhou between January 2017 and June 2020 were included in the study. All patients were randomized into 2 groups of 80 each: patients who received lienal polypeptide injection combined with FOLFOX4 (lienal polypeptide + FOLFOX4 group) and patients who received lienal polypeptide injection combined with XELOX (lienal polypeptide + XELOX group). All patients were given six rounds of treatment. Two-year follow-up assessments of the clinical efficacy, immunity, nutritional status, quality of life and toxicity or adverse effects were conducted 1 months after the end of treatment. Results: Compared with the lienal polypeptide + FOLFOX4 group, the disease control rate (DCR) and objective response rate (ORR) of the lienal polypeptide+XELOX group were dramatically improved (all P<0.05). The percentage of CD3+ T cells, CD4+ T cells and NK cells, the EORTC QLQ-C30 scores and the level of PNI in the lienal polypeptide+XELOX group were higher (all P<0.05). NLR, LMR, CA125, CA199, and CEA were significantly decreased (all P<0.05). In terms of adverse effects, the incidence of leukopenia, neutropenia, neurotoxicity, oral mucositis, and hand foot syndrome in the lienal polypeptide + XELOX group were remarkably decreased compared with the lienal polypeptide + FOLFOX4 group (all P<0.05). No difference in progression-free survival (PFS) and overall survival (OS) was detectable (all P>0.05). Conclusion: Compared with lienal polypeptide injection combined with FOLFOX4, lienal polypeptide injection combined with XELOX has a significant advantage in decreasing the incidence of adverse events and improving the quality of life of Ⅲ/Ⅳ colon cancer patients.