摘要
目的:评估奥沙利铂一线用于治疗晚期结直肠癌后与雷替曲塞联合再引入二线治疗的疗效及安全性。方法:收集2010年5月至2014年12月广西中医药大学附属瑞康医院收治的48例晚期结直肠癌患者,根据一线应用奥沙利铂的情况分为两组:A组(一线使用不含奥沙利铂方案)20例;B组(一线使用含奥沙利铂方案)28例。二线治疗方案:雷替曲塞3 mg/m^2,静脉滴注,d1;奥沙利铂100~130 mg/m^2,静脉滴注,d1;每21天1次。结果:48例均可评价疗效,两组有效率分别为30.0%(6/20)、32.1%(9/28);疾病控制率分别为80.0%(16/20)、75.0%(21/28);中位无进展生存期分别为6.5个月、7.0个月;中位总生存期分别为10个月、13个月;两组有效率、疾病控制率、中位无进展生存期及中位总生存期比较差异均无统计学意义(P=0.264,0.514,0.713,0.788)。主要不良反应为骨髓抑制、转氨酶异常和胃肠道反应,以Ⅰ~Ⅱ级为主;两组感觉神经异常Ⅰ~Ⅱ级发生率相近。结论:奥沙利铂再引入联合雷替曲塞二线化疗对曾使用过奥沙利铂一线化疗的患者仍然有效,无耐药性,安全可行,对不能接受伊立替康二线治疗的晚期结直肠癌患者是较好选择。
Objective： To investigate the efficacy and toxicity of oxaliplatin reintroduction combined with raltitrexed as second-line che- motherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients. Methods： The 48 evaluable pa- tients with advanced colorectal cancer following disease progression prior to the first-line chemotherapy were treated with oxaliplatin and raltitrexed （raltitrexed 3 mg/m2 ivgtt dl, oxaliplatin 100-130 mg/m2 ivgtt dl, q21d）. All 48 patients were divided into two groups： Group A, non-oxaliplatin-based regimens as the first-line chemotherapy, 20 cases; Group B, oxaliplatin-based regimens as the first-line chemotherapy, 28 cases. Each group was evaluated every two cycles. Results： The response rates （RR） of Groups A and B were 30.0% （6/20） and 32.1% （9/28）, the disease control rates （DCR） were 80.0% （16/20） and 75.0% （21/28）, the median progression free survival time （mPFS） was 6.5 and 7.0 months, and the median overall survival time （mOS） was 10 and 13 months, respectively. No statistical sig- nificance was observed between the two groups in their RR, CR, mPFS, and mOS （P=0.264, 0.514, 0.713, 0.788）, respectively. The most common adverse effects observed were I-Ⅱ grades of bone marrow suppression, aminotransferase abnormality, and digestive toxici- ties. The incidence of neurotoxicity （ I-Ⅱ grades） between the two groups was similar. Conclusion： Instead of irinotecan combined with raltitrexed, oxaliplatin reintroduction combined with raltitrexed for second-line chemotherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients is feasible.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2016年第5期188-193,共6页
Chinese Journal of Clinical Oncology
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题项目(编号:Z2015434)
广西中医药大学自然科学研究青年基金项目(编号:QN14011)资助~~
关键词
晚期结直肠癌
奥沙利铂
雷替曲塞
回顾性分析
advanced colorectal cancer, oxaliplatin, raltitrexed, retrospective studies
