奥沙利铂联合替吉奥治疗晚期结直肠癌的疗效观察

Curative effect of oxaliplatin combined with S-1 in treatment of advanced colorectal cancer

目的分析奥沙利铂联合替吉奥治疗晚期结直肠癌的疗效。方法以2013年1月—2015年8月陕西省商洛市第二人民医院收治的90例结肠、直肠癌患者为研究对象,根据住病历顺序号分为观察组和对照组,每组45例。对照组采用奥沙利铂联合氟尿嘧啶的化疗方案,4周为1个治疗周期;观察组采用奥沙利铂联合替吉奥的化疗方案,21 d为1个治疗周期。比较两组的疗效、不良反应、生活质量及1年生存率。结果治疗后,观察组的总缓解率高于对照组,疾病控制率低于对照组,但两组间比较,差异均无统计学意义。治疗期间,两组Ⅰ度和Ⅱ度不良反应发生率比较,差异均无统计学意义;Ⅲ度和Ⅳ度的不良反应中,观察组的胃肠道反应、肝功能受损、白细胞减少的发生率显著低于对照组,差异有统计学意义(P<0.05);其他各项间比较,差异均无统计学意义。两组间SF-36量表中各项评分差值间无统计学意义。观察组治疗后1年生存率为46.67%(21/45),对照组治疗后1年生存率为42.22%(19/45),两组1年生存率比较,差异无统计学意义。结论奥沙利铂联合替吉奥与奥沙利铂联合氟尿嘧啶化疗方案治疗晚期结直肠癌的疗效以及对患者生活质量的影响效果相当,但奥沙利铂联合替吉奥的胃肠道、肝及骨髓抑制的不良反应情况优于奥沙利铂联合氟尿嘧啶化疗方案。

Objective To analyze the curative effect of oxaliplatin combined with S-I in the treatment of advanced colorectal cancer. Methods Totally 90 cases of patients with advanced colorectal cancer in Shangluo No.2 Provincial People＇s Hospital from January 2013 to August 2015 were divided into observation group and control group, 45 cases in each group. Patients in control group were treated with oxaliplatin combined with fluorouracil, 4 weeks for one cycle of treatment, and patients in observation group were treated with oxaliplatin combined with S-1, 21 d for one cycle. The curative effects, adverse reactions, life quality, and one year survival rate were compared between two groups. Results After treatment, the total remission rate of observation group was higher than that of control group, and the disease control rate was lower than that of the control group, but there was no significant difference between the two groups. During the treatment, there were no significant differences in Ⅰ degree and Ⅱ degree adverse reactions between two groups; But the adverse reactions of level Ⅲ and level Ⅳ of gastrointestinal reaction, liver function damage, reduce the incidence of white blood cells in observation group were significantly lower than that of control group （P 〈 0,05）. There was no significant difference between the two groups in the SF-36 scale scores. The one year survival rate of observation group was （21/45）, and the survival rate of the control group after treatment was 42.22% （19/45） in the control group, and there was no significant difference between the two groups in the one year survival rate. Conclusion Compared with oxaliplatin combined with fluorouracil, oxaliplatin combined with S-1 has equivalent efficacy and life quality, but the adverse reactions in gastrointestinal tract, liver, and marrow were better.