埃克替尼与卡培他滨治疗老年结直肠癌疗效比较

Clinic Research on Icotinib and Capecitabine in the Treatment of Senile Advanced Colorectal Cancer

目的 探讨埃克替尼与卡培他滨治疗老年结直肠癌患者的临床疗效.方法 选择2011年10月-2013年2月唐山市工人医院肿瘤科收治的结直肠癌患者41例,根据治疗药物的不同将患者分为埃克替尼组（20例）和卡培他滨组（21例）.埃克替尼组于每天三餐前用温水送服埃克替尼125 mg,3次/d,直到疾病进展、死亡或发生不可耐受的毒副作用;卡培他滨组给予卡培他滨1 250 mg/m2口服,2次/d,连用14 d,停用1周,连用3个周期.治疗2个月后,观察两组患者近期疗效及毒副作用.结果 治疗2个月后,埃克替尼组生活质量改善率[卡氏功能状态（KPS）评分提高＋稳定者]为70%（14/20）、卡培他滨组为29%（6/21）,埃克替尼组生活质量改善率高于卡培他滨组（χ2=4.387,P=0.007）.埃克替尼组部分缓解（PR）2例、稳定（SD）5例、进展（PD）13例,卡培他滨组PR 8例、SD 7例、PD 6例,两组临床疗效比较,差异有统计学意义（u=2.334,P=0.001 9）.埃克替尼组腹泻、皮疹发生率高于卡培他滨组、白细胞计数下降发生率低于卡培他滨组,差异均有统计学意义（P〈0.05）.两组均无Ⅲ～Ⅳ度毒副作用发生,经对症处理和营养支持治疗后均可恢复.结论 卡培他滨治疗老年结直肠癌的近期疗效优于埃克替尼,但埃克替尼组的患者生活质量改善明显.

Objective To study the clinical efficacy of Icotinib and Capecitabine in the treatment of senile advanced colorectal cancer. Methods 41 patients with senile advanced colorectal cancer were divided into Icotinib group （ n = 20） and Capecitabine group （n = 21 ） based on the treatment. Patients in Icotinib group were given Icotinib 125 mg, 3 times per day until disease progression or intolerable toxicity. Patients in Capecitabine group were given Capecitabine 1 250 mg/m2, 2 times per day for 14 days and then stopped for one week, in succession for 3 cycles. After treatment for 60 days, the short - term efficacy, side effects and quality of life of the two groups were evaluated. Results After two - month treatment, 70% （14/20） in Icotinib group and 20% in Capecitabine group had improved or stable KPS score. The life quality in the former was significantly better than that of the latter （x2 =4. 387, P =0. 007） . In the Icotinib group, 2 cases had partial remission, 5 cases were stable and 13 cases progressed; While in the Capecitabine group, 8 cases had partial remission, 7 cases were stable and 6 cases pro- gressed. The efficacy between the two groups showed statistically significant difference （ u = 2. 334, P = 0. 001 9 ） . Patients in Icotinib group had higher incidence of diarrhea and rash, lower incidence of the decline of white blood cell （P 〈 0.05 ） . No ca- ses in the two groups had Ill - IV level side effect, and all the cases recovered after symptomatic treatment and nutrient sup- port. Conclusion The short - term effect in the treatment of senile advanced colorectal cancer in Capecitabine group is superior to that in Icotinib group, but the life quality improved significantly in Icotinib group.