沙利度胺联合 mFOLFOX 方案治疗晚期结肠癌的临床观察

Clinical observation of thalidomide combined with mFOLFOX in the treatment of advanced colon cancer

目的：探讨沙利度胺联合 mFOLFOX 方案治疗晚期结肠癌的疗效、安全性及其对血清血管内皮生长因子（VEGF）的影响。方法100例晚期结肠癌患者按数字表法随机分为两组，联合组50例给予沙利度胺联合标准 mFOLFOX 方案治疗，对照组50例给予标准 mFOLFOX 方案治疗，检测两组治疗前和治疗4个周期后血清 VEGF 浓度，比较两组临床疗效、安全性。结果联合组、对照组有效率分别为42％、38％，临床收益率分别为78％、68％，中位疾病进展时间分别为110 d、107 d，两组差异均无统计学意义（均 P ＞0．05）；联合组、对照组治疗4个周期后血清 VEGF 浓度分别为（317．40±55．54）ng／L、（330．84±64．48）ng／L，均较治疗前显著下降，联合组下降的幅度更明显，两组差异有统计学意义（t ＝11．634，P ＝0．000）。结论沙利度胺联合mFOLFOX 方案治疗晚期结肠癌未能显著提高临床疗效，但能降低血清 VEGF 浓度。

Objective To discuss the efficiency and safety of thalidomide combined with mFOLFOX in trea-ting advanced colon cancer.In addition,to observe the influence of mFOLFOX combined with thalidomide on serum vascular endothelial growth factor（VEGF）leveles.Methods One hundred patients with advanced colon cancer were divided randomly into two groups by digital table method.In the combined group,fifty patients were treated by mFOL-FOX combined with thalidomide.In the control group,fifty patients were treated by mFOLFOX alone.All the patients were tested serum VEGF before and after four cycle of chemotherapy.Results The response rate was 42% in the combined group vs.38% in the control group.Higher clinical benefit rate was found in the combined group （78% vs. 68%）.The median time to progression（TTP）was 110 days vs.107 days.The differents between the two groups were not statistically significant（all P 〉0.05）.After treatment of 4 cycles,the serum VEGF concentration of combined group and control group were respectively（317.40 ±55.54）ng/L and （330.84 ±64.48）ng/L,which were signifi-cantly decreased compared with pretreafment.The combination group decreased more obviously,the difference between the two groups were statistical significance（t =11.634,P =0.000）.Conclusion Combined thalidomide with mFOL-FOX can′t improved clinical curative effect on the advanced colon cancer significantly.However,thalidomide can re-duce the levels of serum VEGF,and improve the quality of life.