FFP时辰化疗+LMS治疗中晚期大肠癌41例临床分析

Chronomodulated Chemotherapy of Oxaliplatin Combined 5-FU and CF Plus Levamisole on Colorectal Cancer of 41 Cases

目的降低大肠癌患者术后复发率,提高中晚期大肠癌患者的生存率。方法将71例中晚期大肠癌患者随机分成2组。治疗组41例,采用FFP(5-氟尿嘧啶、亚叶酸钙、奥沙利铂)时辰化疗+左旋咪唑(LMS)治疗:①第1天15:00-17:00给予奥沙利铂(L-OHP)150mg/m2静脉滴注;②采用微电脑控制的全自动注药泵注入5-氟尿嘧啶(5-FU)4～5g,以正弦速率在第1天22:00至第2天上午10:00注入,上午4:00达到最高峰,持续5d;③亚叶酸钙(CF)200mg/d,每天在5-FU之前注入,连用5d,3～4周为1周期;④左旋咪唑(LMS)50mg口服,3次/d。对照组30例,给予L-OHP150mg/m2、CF200mg/m2、5-FU500mg/m2分别静脉滴注。观察2组疗效及不良反应。结果治疗组和对照组1、2、3年生存率分别为96.23%、71.10%、60.83%和80.86%、67.38%、32.44%;1、2、3年肿瘤进展(TTP)率分别为58.26%、28.16%、28.16%和74.45%、58.22%、50.76%,2组比较差异均有统计学意义(均P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论FFP时辰化疗+LMS治疗中晚期大肠癌可以起到增效、减毒作用,效果较为满意,是治疗中晚期大肠癌的有效方法。

Objective To explore the therapeutic efficacy of chronomodulated chemotherapy of oxaliplatin combined 5-FU and CF （FFP） plus levamisole （LMS） on colorectal cancer. Methods 71 patients with advanced colorectal cancer were randomly divided into two groups. Experiment group（n=41） was employed the chronomodulated chemotherapy of FFP plus LMS： （1）Oxaliplatin （L-OHP） was injected at 15：00-17：00 in the first day;（2）5-FU was infused in sine velocity with an auto-infusion pump that controlled by a microcomputer from 22：00 of the first day to 10：00 of the next day with a concentration peak at 4.00,lasted 5 days;（3） Leucovorin（CF）was infused before administration of 5-FU everyday, lasted 5 days, 3-4 weeks repeatedly;（4）All patients received LMS 50 mg p.o.t.i.d, on days 1-3,every 14 days for 12 months. Control group （n=30） was treated by injecting L-OHP 150 mg/m^2 ,CF 200 mg/m^2 and 5-FU 500 mg/m^2 respectively. The therapeutic efficacy and adverse drug reaction were investigated. Results The 1,2,3 year survival rate of experiment group and control group was 96.23% ,71.10% ,60.83% and 80.86%, 67.38%,32.44%,respectively （P〈0. 05）. The 1,2,3 year TTP rate of experiment group was significantly lower than those of control group（58.26% ,28.16% ,28.16% vs 74.45% ,58.22%, 50.76% ;P〈0.05）. The percentage of adverse drug reactions had no significant difference between the two groups（P〉0.05）. Conclusion The combination of chronomodulated chemotherapy of FFP with LMS may be more effective and may cause the lower adverse drug reactions on advanced colorectal carcinoma.