雷替曲塞与卡培他滨联合奥沙利铂治疗老年晚期结直肠癌的疗效比较

Comparison of the combined raltitrexed-oxaliplatin and combined xeloda-oxaliplatin in the treatment of senile advanced colorectal carcinoma

目的探讨雷替曲塞与卡培他滨联合奥沙利铂治疗老年晚期结直肠癌的疗效和安全性。方法 64例晚期大肠癌患者随机分为2组,治疗组33例,予以雷替曲塞3 mg/m2,第1天,静脉注射15 min;奥沙利铂130 mg/m2,静脉滴注3 h,第1天;每3周重复1次。对照组31例,予以XELOX方案:卡培他滨1 000 mg/m2,2次/d,口服,第1～14天;奥沙利铂130mg/m2,静脉滴注3 h,第1天;每3周重复1次。结果治疗组与对照组分别有32例和30例可评价疗效,有效率(RR)分别为49.2%和47.9%;中位疾病进展时间(TTP)分别为8.2个月与7.9个月,2组疗效比较无统计学意义(P>0.05)。治疗组转氨酶升高、中性粒细胞减少和疲乏发生率明显高于对照组(P<0.05),手足综合征与恶心、呕吐发生率低于对照组(P<0.05)。结论雷替曲塞联合奥沙利铂方案一线治疗晚期结、直肠癌疗效确切,与XELOX方案相当,不良反应能耐受。雷替曲塞联合奥沙利铂方案用药更为方便,安全性更好。

Objective To observe the efficacy and safety of the combined raltitrexed-oxali- platin and xeloda-oxaliplatin in the treatment of senile advanced colorectal carcinoma. Methods Six- ty-four advanced colorectal cancer patients were divided into two groups. The treatment group （ n = 33） was administered intravenously raltitrexed 15 min drip with 3 mg/m2, oxaliplatin 3-hour drip with 130 mg/m2 on day 1. The control group （ n = 31 ） was administered capecitabine 1000 mg/m2, orally 2 times/day, the first one to 14 days, oxaliplatin 3-hour drip with 130 mg/m2 on day 1. Re- suits A total of 32 patients in the treatment group and 30 patients in the control group were evalu- ated. Effective rates were 49.2 % and 47.9 %, respectively. Median TTP were 8.2 and 7.9 months, respectively. No significant statistical difference was found in the short-term efficacies of the two groups （P 〉 0.05）. Adverse reactions compared to the elevated transaminase enzymes in the treatment group was higher than that in the control group; There were more patients who de- veloped tiredness and reduced neutropenia in the treatment group （P 〈 0.05）. There were more pa- tients who developed hand - foot syndrome and vomiting in the control group （P 〈 0.05）. Conclu- sion The combined raltitrexed-oxaliplatinl has similar efficacy with that of XELOX. But it is more convenient and safer.