卡培他滨单药方案与FOLFOXIRI方案在老年晚期结肠直肠癌姑息化疗中的疗效及毒副反应比较

Chemo efficacy comparison between capecitabine single drug and FOLFOXIRI program in the elderly patients with advanced colorectal cancer

目的比较卡培他滨单药方案与FOLFOXIRI方案在老年晚期结肠直肠癌姑息化疗中的疗效及毒副反应。方法选择在我院诊治的72例老年晚期结肠直肠癌患者,应用随机数字表法将老年晚期结肠直肠癌患者分为两组,一组采用卡培他滨单药方案,另一组采用FOLFOXIRI方案进行姑息化疗,比较两组化疗效果和毒副反应。结果两组患者接受卡培他滨单药方案与FOLFOXIRI方案治疗后,肿瘤控制率分别为77.8%和83.3%,组间差异无统计学意义（P〉0.05）。FOLFOXIRI方案在客观有效率和肿瘤进展时间方面优于卡培他滨单药方案[22.2%对41.7%,（4.9±2.3）对（6.5±2.2）个月,P〈0.05]。两组方案的毒副反应主要包括血液学毒性、恶心呕吐、腹泻和手足综合征等,均以Ⅰ~Ⅱ级为主,且患者均耐受,两组在骨髓抑制、外周神经炎、口腔黏膜炎和肝功能损害等毒副反应方面差异均无统计学意义（P〉0.05）,但出现手足综合征、恶心呕吐以及腹泻的发生率,FOLFOXIRI方案化疗组明显低于卡培他滨单药方案化疗组,差异具有统计学意义（P〈0.05）。结论卡培他滨单药方案与FOLFOXIRI方案均能有效控制晚期结肠直肠癌的进展,但是不良反应方面FOLFOXIRI方案略优于卡培他滨单药方案。

Objective To compare the chemo efficacy of capecitabine single drug with FOLFOXIRI program in the elderly patients with advanced colorectal cancer. Methods Total of 72 cases of elderly patients with colorectal cancer were randomly divided into two groups. One group received capecitabine single drug palliative chemotherapy and the another received FOLFOXIRI palliative chemotherapy. The curative effect and toxic and side effects between two groups were compared. Results The cancer situation of both two groups were improved after palliative chemotherapy. The tumor control rate in the project of capecitabine single drug and FOLFOXIRI were 77.8% and 83.3% respectively with no significant difference（P〉0.05）. While the effective rate and the average tumour progression in both two groups were 22.2%,（4.9±2.3） month and 41.7%,（6.5±2.2） month, which showed that the FOLFOXIRI program had obvious advantage over the program of capecitabine single drug in the effective rate and the average tumour progression（P〈0.05）. The toxic and side effects, such as hematologic toxicities, nausea and vomiting, diarrheaand and hand-foot syndrome were observed in both groups. However, the occurrence rate of hand-foot syndrome, nausea and vomiting, diarrhea in the program of FOLFOXIRI were significantly lower than those in capecitabine single drug（P〈0.05）. Conclusion Both program of capecitabine single drug and FOLFOXIRI can effectively control the cancer situation. However, the FOLFOXIRI program shows better performance than capecitabine single drug in the whole treatment.