雷替曲塞联合顺铂双途径化疗治疗晚期大肠癌临床研究

Clinical study of raltitrexed combined with cisplatin for the double-channel chemotherapy in the treatment of patients with advanced colorectal cancer

目的 观察双途径（腹腔＋静脉）化疗治疗晚期大肠癌的安全性和有效性.方法 临床收集有明确病理诊断的晚期大肠癌患者40例,按随机数字表法分为2组：双途径化疗组选择雷替曲塞静脉全身化疗联合顺铂（DDP）腹腔灌注化疗,静脉化疗组选择雷替曲塞联合DDP静脉全身化疗,每组各20例,21d为1个周期,2个周期后评价疗效.分别从近期有效率、无进展生存（PFS）、中位总生存（mOS）、不良反应和生存质量等方面进行观察.结果 可评价的40例2组患者中,双途径化疗组Ⅲ～Ⅳ度不良反应的发生率为3.0％（3/100例次）、静脉化疗组为11.0％（11/100例次）;2组近期有效（完全缓解＋部分缓解）率分别为35.0％（7/20）、25.0 ％（5/20） （P＜0.01）;PFS分别为6.0和4.0个月（P＜0.01）;mOS分别为20.0和5.0个月（P＜0.01）.两组患者生存质量在治疗后有显著提高（P＜0.01）.结论 双途径化疗治疗晚期大肠癌患者不良反应较轻,能不同程度地提高患者生存期和生活质量.

Objective To investigate the safety and efficiency of three different double-channel chemotherapy regimens in the treatment of advanced colorectal cancer. Methods 60 cases of advanced colorectal cancer with definite pathological diagnosis were randomly divided into three groups with 20 cases per group： the CPT-11＋DDP group, the rahitrexed＋DDP group and the fluorouracil＋DDP group. Every 21 days was one course of treatment, all the patients received at least 2 cycles of treatment. The recent effect, PFS , mOS, toxicity and quality of life were observed respectively. Results 40 patients were evaluated that the Ill- 1V degree adverse effect were 3.0 % （3/100） and 11.0 % （11/100）. The recent effect （CR＋PR） of the 2 groups were 35.0 % （7/20） and 25.0 % （5/20） respectively, the PFS and mOS were 6.0, 4.0 months （P 〈 0.01） and 20.0, 5.0 months respectively （P 〈 0,01）. The quality of life were improved obviously after treatment （P 〈 0.01）. Conclusion Double-channel chemotherapy regimens in the treatment of advanced eolorectal cancer can be less toxic and improve the quality of life of patients.