替吉奥维持治疗晚期结直肠癌的临床疗效

Clinical value of S-1 capsule in the maintenance treatment of advanced metastatic colorectal cancer

目的探讨替吉奥在晚期转移性结直肠癌维持治疗中的价值。方法选取2008年1月至2012年6月间经不含替吉奥方案化疗的65例晚期结肠癌,按患者自己意愿随机分为维持治疗组和观察组。维持治疗组34例,给予替吉奥维持治疗（40 mg/m^2,分两次口服,d1-28）;观察组31例,采用观察或支持治疗,直至疾病进展再接受进一步治疗。观察两组患者的疾病进展时间（TTP）及不良反应发生情况。结果维持治疗组患者的中位TTP为9.6个月（95%CI为7.612-10.682个月）,观察组患者的中位TTP为6.0个月（95%CI：5.282-6.718）,两组差异有统计学意义（P〈0.01）。维持治疗组的主要不良反应为血液学毒性、消化道反应,极少有手足综合征,无肝肾功能损害。结论替吉奥维持治疗晚期转移性结直肠癌患者,可显著延长无疾病进展时间且耐受性良好,值得临床推广。

Objective To evaluate the value of S-1 capsule maintenance therapy with advanced metastatic colorectal cancer. Methods From January 1st,2008 to June 1st,2012,collecting patients with advanced metastatic colorectal cancer in the Department of Medical Oncology,the 180 thHospital of People＇ s Liberation Army,after they had achieved clinical response from first-line chemotherapy,they received two different treatment strategies,according to the patient＇ s own intention. Maintenance therapy group（ 34 cases） were treated with S-1 capsule maintenance therapy of S-1 capsule 40 mg / m^2 po bid d1 - 28,q42 d. Observation group（ 31 cases） did not receive any further chemotherapy until disease progression. Time to progression（ TTP） of two groups,and the toxicity of the maintenance group were observed. Results The median TTP was 9. 6 mo vs 6. 0 mo of patients in maintenance therapy group and observation group,respectively,the differences between them were statistically significant（ P〈0. 01）. The major side effects in maintenance therapy group were hand-foot syndrome,digestive tract reaction,hematology toxicity. Nothing impairment of liver and kidney function were observed. Conclusion S-1 capsule maintenance therapy could benefit the patients with advanced metastatic colorectal cancer by extending TTP,and is generally well tolerated,worthy of enlarging the sample for further research.