摘要
目的：探讨雷替曲塞单药与联合奥沙利铂或伊立替康方案二线治疗晚期结直肠癌的疗效和安全性。方法收集70例有明确病理诊断的晚期结直肠癌患者的临床资料，按化疗方案分为3组：A组（25例）：雷替曲塞2-3 mg／m^2，静脉滴注，d1；B 组（22例）：奥沙利铂100-130 mg／m^2，静脉滴注， d1，雷替曲塞剂量及用法同 A 组；C 组（23例）：伊立替康160-180 mg／m2，静脉滴注，d1，雷替曲塞剂量及用法同 A 组，均每3周重复，每2个周期评价疗效，最多治疗6个周期。结果70例患者均可评价疗效，A、B、C组有效率分别是4．0％（1／25）、31．8％（7／22）和21．7％（5／23），3组疗效比较差异有统计学意义（P＜0．05），其中A组有效率低于B、C组（P＜0．05），B组与C组有效率比较差异无统计学意义（P＞0．05）；疾病控制率分别是52．0％（13／25）、77．2％（17／22）、73．9％（17／23）；中位无进展生存期分别是3．8个月、6．5个月、5个月；中位总生存期分别是9个月、13个月、11个月，3组比较差异均无统计学意义（P＞0．05）。最常见的毒性反应是粒细胞减少、转氨酶异常、消化道反应，以Ⅰ-Ⅱ级为主，粒细胞减少Ⅰ-Ⅱ级发生率分别为4．0％（1／25）、31．8％（7／22）、26．1％（6／23），B、C组明显高于A组（P＜0．05）。转氨酶异常Ⅰ-Ⅱ级发生率分别为20．0％（5／25）、31．8％（7／22）、26．1％（6／23），差异无统计学意义（P＞0．05）。腹泻Ⅰ-Ⅱ级发生率A组4．0％（1／25）、B组4．5％（1／22）低于C组34．8％（8／23）（P＜0．05）。结论雷替曲塞单药方案在晚期结直肠癌二线化疗中安全有效。雷替曲塞联合奥沙利铂或伊立替康方案疗效优于单药方案，毒性可耐受，值得临床推广应用。
Objective To explore the efficacy and toxicity of raltitrexed alone versus raltitrexed in combination with oxaliplatin/irinotecan as second-line chemotherapy for advanced colorectal cancer.Methods Seventy patients with pathologically confirmed advanced colorectal cancer were divided into three groups according to the chemotherapy regimens.Twenty-five cases in Group A received intravenous drip of raltitrexed（2-3 mg/m^2 , d1 ）,twenty-two cases in Group B received intravenous drip of oxaliplatin（100-130 mg/m2 ,d1 ） and raltitrexed（2-3 mg/m^2 ,d1 ）,twenty-three cases in Group C received intravenous drip of irinotecan（160-180 mg/m2 ,d1 ） and raltitrexed（2-3 mg/m2 ,d1 ）,and three weeks as a treatment cycle.The efficacy was assessed every two cycles.The treatment at most lasted for six cycles.Results The assessment on efficacy was performed among the 70 patients.The effective rates of Groups A,B and C were 4.0%（1/25）,31.8%（7/22） and 21.7%（5/23）,respectively,which showed a statistically significant difference among three groups（P〈0.05）.The effective rate was lower in Group A compared with that in Groups B and C（P〈0.05）,and it showed no statistically significant difference between group B and group C （P〉0.05）.The disease control rates of Groups A,B and C were 52.0%（13/25）,77.2%（17/22） and 73.9%（17/23）,respectively.The median progression-free survivals of Groups A,B and C were 3.8,6.5 and 5 months,respectively.The median overall survivals of Groups A,B and C were 9,13 and 11 months, respectively.There were no significant differences in the disease control rate,progression-free survival,or overall survival among three groups （P〉0.05）.The common toxicity responses of three groups were granulopenia,abnormal transaminase and digestive tract reactions,dominated by gradeⅠ-Ⅱ.The incidences of granulopenia of gradeⅠ-Ⅱof Groups A,B and C were 4.0%（1/25）,31.8%（7/22） and 21.6%（6/23）, respectively.The incidences of Groups B and C were significantly
出处
《广西医学》
CAS
2015年第4期492-496,共5页
Guangxi Medical Journal
