替吉奥(S-1)联合塞来昔布胶囊对老年晚期结直肠癌的疗效及生活质量的影响

Tegafur/gimeracil/oteracil(S-1) in combination with celecoxib for elderly patients with advanced colorectal cancer:efficacy and influence on quality of life

目的:观察替吉奥(S-1)联合塞来昔布治疗老年结直肠癌的疗效以及不良反应与患者生活质量情况。方法:对2010年1月—2014年5月间确诊为晚期结直肠癌的31例老年患者给以口服S-1胶囊,40 mg/次,塞来昔布胶囊0.2 g/次,均2次/d,连服2周,休息1周,3周为1个周期。6个周期后观察疗效、患者生存质量与不良反应,以及D二聚体、CEA、CA19-9水平变化。结果:31例患者缓解率64.5%,疾病控制率87.1%;患者的KPS评分、躯体功能、社会功能、情绪功能较前改善,肿瘤导致的疲乏、疼痛、睡眠障碍、食欲减退等不适均较化疗前明显减轻(均P<0.05)。化疗后D二聚体、CEA、CA19-9水平明显降低(均P<0.05)。不良反应主要为骨髓抑制、食欲下降及恶心呕吐,均经对症处理缓解。结论:S-1联合塞来昔布胶囊治疗老年晚期结直肠癌疗效显著,且能提高患者生存质量,降低D二聚体、CEA、CA19-9水平,毒副作用可以耐受。

Objective：To investigate the efficacy,adverse reactions and quality of life of elderly colorectal cancer patients treated with celecoxib plus Tegafur/gimeracil/oteracil（S-1）.Methods：h irty-one elderly patients diagnosed with advanced colorectal cancer from January 2010 to May 2014 were enrolled.All patients received oral administration of twice daily 40 mg of S-1 and 0.2 g celecoxib for two weeks followed by one-week break,with 3 weeks as a treatment cycle.The treatment response,patients’ qualityof life and adverse reactions as well as the changes in D-Dimer,CEA and CA19-9 levels were observed after 6 treatment cycles.Results：In the 31 patients,the response rate was 64.5% and the disease control rate was 87.1%,respectively.Karnofsky score and physical,social and emotion function of the patients were all significantly improved,and the discomfort caused by tumor burden such as fatigue,pain,sleep disorders and anorexia were all signii cantly relieved at er chemotherapy（all P〈0.05）.The levels of D-Dimer,CEA and CA19-9 were signii cantly decreased compared with pretreatment values（all P〈0.05）.The adverse reactions consisted mainly of myelosuppression,loss of appetite,nausea and vomiting,which were all relieved by symptomatic treatments.Conclusion：S-1 plus celecoxib has proven efficacy in treatment of elderly patients with advanced colorectal cancer,and it can also improve the patients’ quality of life and decrease the levels of D-Dimer,CEA and CA19-9,with tolerable toxicity.