CapeOX方案治疗老年病人不可切除的结直肠癌肝转移的意义

Clinical value of oxaliplatin and capetabine in patients with initially unresectable metastatic colorectal cancer

目的探讨CapeOX方案对不可切除的结直肠癌肝转移老年病人的治疗效果。方法对不可切除的转移性结直肠癌老年病人,应用CapeOX方案化疗,每2周期评估一次化疗效果。如化疗后可行手术切除则考虑手术,术后继续CapeOX方案化疗。结果2004年1月至2006年1月共收治符合标准的病人16例,化疗后8例缓解(缓解率50%),其中3例行根治性切除,5例化疗后肿瘤稳定或缓解但未能行肝切除的病人中位生存期为23.2月;4例化疗后稳定;4例化疗无效的病人中位生存期为6.25月。结论CapeOX方案结合肝切除术可使部分病人获得治愈,同时CapeOX化疗方案可以使部分病人肿瘤症状缓解,延长病人生命。

Objective To investigate the clinical value of oxaliplatin and capetabine （CapeOX） in patients with initiallly unresectable metastatic colorectal cancer. Methods Patients with liver-only metastases from coloreetal cancer deemed not optimal for resectable surgery received CapeOX, and were periodically reassessed for reseetability. The therapeutic effects including response rate, resectable rate and prognosis were evaluated. Results Sixteen patients with eligible criteria were included for this analysis. Eight patients（ 50% ）had tumor response in liver metastases, and 7 patients underwent curative surgery. No response was observed in 4 patients with 6.25 months as median survival time. Stable disease condition and partial response were observed in 5 patients without curative surgery and the median survival time was 23.2 months. Two of 7 patients reveiving curative surgery had different complications, and no mortality. At median follow-up of 33.3 months in this group, only 2 relapsed and 2 died. Conclusions Treatment with CapeOX enables tumor reduction and surgical resection of liver-only metastases in some patients, and this discipline therapy may improve prognosis.