草酸铂联合5-氟脲嘧啶/亚叶酸钙治疗晚期结直肠癌的临床研究

Clinical Study on the Treatment of Advanced Colorectal Cancer with Oxaliplatin Combined with 5-Fluorouracil and Leucovolin

目的:观察草酸铂(Oxaliplation,L-OHP)联合5-氟尿嘧啶(5-Fluorouracil,5-FU)/亚叶酸钙(Leucovolin,CF)治疗晚期结直肠癌的近期疗效、毒副反应及无进展生存期。方法:经病理证实的73例晚期结直肠癌患者分为两组,分别采用5-FU/CF(35例)及LOHP+5-FU/CF(38例)方案,进行分组对照研究,治疗方法:(1)5-FU/CF组:CF 200mg/m2,静脉滴注2小时(h),dl,之后给予5-FU 0.5g静脉推注,dl,接下来给予5-FU 3.0g/m2持续静脉滴注48h;(2)L-OHP+5-FU/CF组:L-OHP 85mg/m2,静脉滴注2h,dl,之后给予5-FU/CF,用法同前,以上两种方案均2周重复,每4周为一完整周期,每个受试者均接受两个及以上周期的治疗。结果:两组治疗后有效率:L-OHP+5-FU/CF组52.6%,5-FU/CF组25.7%,(P<0.05)。无进展生存期:L-OHP+5.FU/CF组8.9月,5-FU/CF组5.3月,(P<0.05)。毒副反应主要为感觉神经末梢毒性、粘膜炎、骨髓抑制、恶心、呕吐、腹泻,但多为Ⅰ～Ⅱ度。结论:草酸铂联合5-氟脲嘧啶/亚叶酸钙治疗晚期结直肠癌有较好疗效,不良反应可耐受,值得临床推广。

Objective： To observe the anti-tumor efficacy,toxicity and time to progress of oxaliplatin （L-OHP） combined with 5-fluorouracil （5-FU） and leucovorin （CF） in therapy of advanced colorectal cancer. Methods： 73 patients of advanced colorectal cancer with pathologically confirmation were divided into two groups： one group were treated with 5-fluorouracil and leucovorin （n=35） and the other group were treated with oxaliplatin combined 5-fluorouracil and leucovorin （n=38）. For the former group, CF 200 mg/m^2 iv drip 2 hours,dl, followed by 5-Fu 0.5g iv bolus plus 5-Fu 3.6mg/m^2 iv continuous infusion 48 hours, dl. For the Latter group, L-OHP 85mg/m^2 was given intravenously 2 hours, dl; followed by 5-FU/CF. The chemotherapy was repeated every two weeks and every four weeks was a cycle. All enrolled patients were treated two cycles at least. Results： The curative effect of two groups had significant differences （52.6% vs 25.7%, p〈0.05）, and median time to progression was 8.9 months vs 5.3 months （p〈0.05）. Toxic and side effects were mild neuro-sensory toxicity, mucitis, suppression of bone marrow ,diarhea,nausea and vomiting of grade Ⅰ to Ⅱ commonly. Conclusion： Oxaliplatin with 5-fluorouracil/leucovorin is effective for advanced colorectal cancer, which is tolerated by patients and worth of clinic application widely.