CapeOX和SOX化疗方案治疗晚期结直肠癌的疗效观察

Efficacy of CapeOX and SOX chemotherapy regimens in the treatment of advanced colorectal cancer

目的探讨奥沙利铂+卡培他滨(CapeOX方案)和奥沙利铂+替吉奥(SOX方案)化疗治疗晚期结直肠癌的临床疗效。方法选取2015年1月至2017年1月间大连大学附属新华医院收治的100例晚期结直肠癌患者,采用随机数字表法分为观察组和对照组,每组50例。观察组患者采用CapeOX方案化疗,对照组患者采用SOX方案化疗,比较两组患者临床疗效、不良反应、生活质量、生存率、血清糖链抗原242(CA-242)和血清DR-70水平。结果随访3年,对照组患者脱落3例,观察组患者脱落2例。治疗6周后,观察组患者有效率为39.6%,疾病控制率为91.7%,对照组为31.9%和85.1%,两组比较,差异无统计学意义(P>0.05)。治疗后,两组患者KPS评分均上升,且观察组高于对照组,KPS稳定率(93.8%)高于对照组(63.8%),差异均有统计学意义(均P<0.05)。治疗后,两组患者CA-242和DR-70水平均下降,且观察组下降程度大于对照组,差异均有统计学意义(均P<0.05)。治疗6周后,两组患者均发生血红蛋白减少、血小板减少、白细胞计数降低和周围神经毒性等不良反应,观察组血红蛋白减少、白细胞降低和周围神经毒性发生率均低于对照组(均P<0.05)。随访36个月,观察组患者生存时间为36个月,对照组患者为31.5个月,两组比较,差异无统计学意义(P>0.05)。结论CapeOX化疗方案治疗晚期结直肠癌患者疗效较好,能有效降低血清CA-242和DR-70水平,安全性好。

Objective To explore and analyze the clinical efficacy of oxaliplatin plus capecitabine(CapeOX)and oxaliplatin plus tegafur(SOX)chemotherapy regimens in the treatment of advanced colorectal cancer.Methods One hundred patients with advanced colorectal cancer treated at Xinhua Hospital Affiliated to Dalian University from January 2015 to January 2017 were selected.They were divided into an observation group and a control group with 50 patients in each group using digital table method.The observation group received CapeOX therapy and the control group received SOX therapy.The clinical efficacy,adverse reactions,quality of life,survival rate,serum carbohydrate antigen-242(CA-242)and DR-70 levels were compared between the two groups.Results The patients were followed up for 3 years,3 patients dropped out of the therapy in the observation group and 2 patients dropped out of the therapy in the control group.Response rate and disease control rate was 39.6%and 91.7,respectively in the observation group and 31.9%and 85.1%,respectively in the control group(P>0.05).Karnofsky performance status scale(KPS)score increased in both groups after the treatment with the observation group higher than the control group(P<0.05).The stable rate of KPS was 93.8%in the observation group which was higher than 63.8%of the control group(P<0.05).After treatment,the levels of CA-242 and DR-70 decreased in the two groups,and the reduction of CA-242 and DR-70 levels were lower in the observation group than in the control group(all P<0.05).At 6 weeks after the treatment,adverse reactions including reduced hemoglobin,thrombocytopenia,leukopenia and peripheral neurotoxicity occurred in the two groups.The incidence of thrombocytopenia,leukopeniaand peripheral neurotoxicity was lower in the observation group than in the control group(P<0.05).The two groups were followed-up for 36 months,the survival period was 36 months in the observation group and 31.5 months in the control group(P>0.05).Conclusion Compared with SOX chemotherapy,Cape OX chemotherapy is effective in the treatment of advanced colorectal cancer,which can effectively reduce serum CA-242 and DR-2 with good safety.