祛瘀解毒方联合卡培他滨节拍化疗治疗老年晚期结直肠癌的临床分析

Clinical analysis of Quyu Jiedu Decoction combined with capecitabine metronomic chemotherapy in the treatment of elderly advanced colorectal cancer

目的观察祛瘀解毒方结合卡培他滨节拍化疗治疗老年结直肠癌患者的临床疗效及安全性。方法以2013年7月到2015年6月在我院住院和门诊治疗的23例老年大肠癌患者作为研究对象,给予中药祛瘀解毒方持续口服,加卡培他滨小剂量500mg,2次/d持续治疗。连续服用4周为1个化疗周期,可连续多程治疗;如患者出现严重不适,可休息1周再进入下一周期治疗。化疗直至患者自愿退出、不能耐受或死亡。对至少接受过2个化疗周期的患者进行疗效评估。疗效评价按RECIST1.1标准、总生存期、生活质量评分(FACT-C V4.0)标准评估。不良反应按NCI CTC3.0标准评估。结果 2月后疗效评估,23例患者中,完全缓解(CR)0例(0/23),部分缓解(PR)4例(17.4%,4/23),疾病稳定13例(56.5%13/23),疾病控制率为73.9%(17/23),中位总生存时间为11.3个月。生活质量评分治疗后身体状况、情绪状况、功能状况、附加关注和量表总分与治疗前比较均有提高,差异均有显著性意义(P<0.05),社会/家庭状况差异均无显著性意义(P>0.05),且治疗2疗程和4疗程后生活质量评分差异均有显著性意义(P<0.05);不良反应均可耐受。结论祛瘀解毒方联合卡培他滨节拍化疗治疗老年晚期肠癌可以有效地控制疾病进展,提高患者生活质量,不良反应较低,值得临床进一步研究评估。

Objective To observe the curative effect and safety of Quyu Jiedu Decoction combined with capecitabine metronomic chemotherapy in elderly patients with colorectal cancer. Methods 23 cases of elderly patients with colorectal cancer who were hospitalized or treated in the outpatient department in our hospital between July 2013 and June 2015 were selected as study objects. All patients orally took Quyu Jiedu Decoction combined with small dose of capecitabine 500 mg, twice / d, given continuously. Continuous administration of 4weeks was 1 course of chemotherapy and the patients were treated for many courses. If there was severe discomfort in patient, they can rest for 1 week and then received next cycle of treatment. Chemotherapy was performed till patients withdraw voluntarily, can not tolerate or die. Patients who underwent at least 2 cycles of chemotherapy were evaluated. Efficacy evaluation was carried out according to RECIST1.1 standard, total survival time and quality of life score（FACT-C V4.0） standard. Adverse reactions were evaluated according to NCI CTC3.0 standard. Results： 2 months later, efficacy evaluation was carried out. In 23 patients, there was no patients（0 / 23）completely remitted（CR）, 4 patients（17.4%, 4 / 23）partially remitted（PR） and 13 patients with stable disease（56.5%, 13 / 23）. The control rate of the disease was 73.9%（17 / 23）, and the median overall survival time was11.3 months. After treatment, the scores of physical condition, emotional status, functional status, additional attention and scale total scores were significantly improved. Compared with those before treatment, there were significant differences（P〈0.05）. There was no significant difference in the social / family status（P〈0.05）. Besides, there was significant difference in the scores of quality of life after 2 courses and 4 courses of treatment（P〈0.05）; Adverse reactions can be tolerated. Conclusion To apply Quyu Jiedu Decoction combined with capecitabine metronomic chemotherapy in the treatment of elderly patients with advanced colorectal cancer can effectively control progression of the disease and improve the quality of life. The incidence of adverse reactions is low and it is worthy of further study and evaluation.