雷替曲塞在120例结直肠癌肝转移治疗中的疗效分析

The Study of Raltitrexed in Treatment of 120 Cases with Colorectal Cancer Liver Metastases

[目的]评价雷替曲塞在治疗晚期结直肠癌肝转移中的疗效和不良反应。[方法]对120例结直肠癌术后肝转移的患者进行化疗,将其随机分为研究组和对照组,每组60例。研究组采用介入下肝动脉灌注雷替曲塞化疗联合栓塞治疗,对照组采用雷替曲塞单药静脉滴注治疗。以上治疗每3周1次。共进行3-6个周期。比较两组的治疗有效率（RR）、疾病控制率（DCR）、中位疾病进展时间、生存率及不良反应情况。[结果]治疗有效率（RR）研究组为38.3%,对照组为20.0%,差异有统计学意义（P=0.027）;疾病控制率（DCR）研究组为66.7%,对照组为45.0%,差异有统计学意义（P=0.017）。中位疾病进展时间研究组为15.4个月,对照组为10.5个月,差异有统计学意义（P=0.000）。研究组1、2年生存率分别为71.7%、56.7%,对照组分别为51.7%、38.3%,差异均有统计学意义（P值分别为0.024、0.044）。[结论]介入下肝动脉灌注雷替曲塞化疗联合栓塞治疗结直肠癌肝转移疗效肯定,不良反应能耐受,值得临床推广。

[Objective]To investigate the efficacy and adverse reactions of raltitrexed in the treatment of advanced colorectal liver metastases. [Methods] 120 patients with advanced colorectal cancer liver metastases were divided into study group（n=60） and control group（n=60）,the former group of which were treated with raltitrexed in hepatic arterial infusion and embolization,and the other group with raltitrexed in intravenous infusion. The treatment lasted for 3 -6 periods; each for 3 weeks.The response rate（RR）,disease control rate（DCR）,median time to progress,survival rate and adverse reactions were observed. [Result]The RR were 38.3% and 20.0% for study and control group respectively（P=0.027）. The DCRs of study group and control group were 66.7% and45.0%（P=0.017）. The median time to progression of study group and control group were 15.4 and10.5 months respectively（P=0.000）. The 1- and 2-year survial rate of study group were 71.7%and 56.7% respectively,and in control group were 51.7% and 38.3%（P=0.024; P=0.044）.[Conclusion] The raltitrexed in hepatic arterial infusion and embolization is of good value in the treatment of advanced colorectal cancer,and it should be applied clinically.