摘要
目的探讨雷替曲塞(Raltitrexed)联合奥沙利铂(L-OHP)治疗术后复发晚期大肠癌的疗效和安全性。方法 84例术后复发晚期大肠癌患者分为3组:A组38例,奥沙利铂(L-OHP)130mg/m2,d1,静脉滴注3h,甲酰四氢叶酸(LV)200mg/m2,静脉滴注2h,续予5-氟尿嘧啶(5-Fu)400mg/m2静脉滴注6～8 h,连用5 d。B组27例,伊利替康(CPT-11)180mg/m2,d1,静脉滴注1.5 h,甲酰四氢叶酸(LV)200mg/m2,静脉滴注2 h,续予5-Fu 400mg/m2静脉滴注6～8 h,连用5 d。C组19例,奥沙利铂(L-OHP)130mg/m2,d1,静脉滴注3h,雷替曲塞(Raltitrexed)3mg/m2,d1,静脉注射15min。三组均每3周重复1次。结果 A、B、C三组有效率(RR)分别为15.8%、18.5%和36.8%;A、B组分别与C组比较,两组RR比较差异均有统计学意义(P<0.05)。三组的疾病控制率(DCR)分别为65.8%、70.4%和78.9%;A、B组与C组比较,两组DCR比较差异均无统计学意义(P>0.05)。三组的中位疾病进展时间(TTP)分别为6.1个月、6.9个月和8.2个月。A组与C组比较,两组TTP差异有统计学意义(P<0.05);B组与C组比较,两组TTP差异无统计学意义。毒性反应方面,C组的黏膜炎发生率明显低于A和B组,具有显著差异;其肝功能异常发生率高于A和B组;其神经毒性与A组基本相同;其腹泻及脱发发生率明显低于B组。结论雷替曲塞联合L-OHP(TOMOX方案)在术后复发晚期结直肠癌的治疗上近期效果优于FOLFOX及FOLFIRI方案,且毒性反应低,患者耐受性好,尤其适合老年患者。
Objective To evaluate the safety and efficacy of raltitrexed plus oxaliplatinl in the treatment of advanced colorectal carcinoma with postoperative recurence. Methods 84 cases of ad- vanced colorectal cancer with postoperative recurence were divided into three groups. 38 cases in group A were given oxaliplatinl 130mg/m2 over 3 hours infusion on day 1, leucovorin 200mg/m2 infusion over 2 hours from day 1 to day 5 and 5-fluorouracil 400mg/m2 for 6 - 8 hours as the same way. 27 cases in group B were given irinotecan 180mg/m2 over 1.5 hours infusion on day 1, leucovorin 200mg/m2 infusion over 2 hours from day 1 to day 5 and 5-fluorouracil 400mg/m2for 6 - 8 hours as the same way. 19 cases in group C were given intravenously raltitrexed 15 minitues drip with 3mg/m2 on day 1, oxaliplatinl 3 hours drip with 130mg/m2 on day 1. The regimen of three groups repeated every 3 weeks was a cycle. Results Groups A and B and C could be evaluated respectively. RR were 15.8%, 18.5% and 36. 8%, comparison of A or B and C in RR has statistic significance. DCR were 65.8% ,70. 4% and 78.9% respectively,comparison of A or B and C in DCR has no statistic significance. And median TIP were 5.2,6. 1 and 8. 3 months respectively, comparison of A and C in TFP has statistic significance, but no significance existed in B and C. As for toxic reaction, the incidence of mueosltis in group C is lower than that in group A and B, there is statistic sig- nificance among them. The incidence of hepatorental toxicity in group C is higer than that in group A and B;the incidence of nervous toxicity in group C is the same as that in group A;the incidence of diarrhea and alopecia in group C is lower than that in group B. Conclusions The recent clinical efficacy of Tomox is better than FOLFOX and FOLFIRI in the treatment of advanced colorectal carcinoma with postoperative re- curence, low toxic reaction and well tolerated, especially in the elderly.
出处
《中国肿瘤临床与康复》
2012年第5期440-442,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
