雷替曲塞与5-氟尿嘧啶、亚叶酸钙联合奥沙利铂治疗晚期结直肠癌的疗效比较

Comparison of the efficacy of raltitrexed with 5-fluorouracil,leucovorin combined with oxaliplatin in the treatment of advanced colorectal cancer

目的比较雷替曲塞联合奥沙利铂与5-氟尿嘧啶/亚叶酸钙联合奥沙利铂对晚期结直肠癌患者的临床效果和安全性。方法选取2014年9月至2016年8月本院收治的104例晚期结直肠癌病患,随机分为对照组和观察组,每组52例。对照组患者采用5-氟尿嘧啶/亚叶酸钙联合奥沙利铂治疗,观察组患者采用雷替曲塞联合奥沙利铂治疗,分析两组患者的临床疗效、不良反应和生存质量。结果观察组患者的临床有效率为36.54%,疾病的控制率为78.85%,对照组患者的临床有效率、疾病控制率分别为34.62%、75.0%,两组相比差异无显著性(P>0.05)。观察组白细胞减少、贫血、恶心、呕吐、高胆红素血症、腹泻、口腔炎、脱发的发生例数均显著低于对照组,差异有显著性(P<0.05)。治疗后,观察组患者的躯体功能、物质功能、心理功能、社会功能评分显著高于对照组,差异有显著性(P<0.05)。结论对于晚期结直肠癌,雷替曲塞联合奥沙利铂和5-氟尿嘧啶亚叶酸钙联合奥沙利铂的治疗效果均比较理想,但雷替曲塞联合奥沙利铂治疗方案更为突出,不良反应少,生存质量高,值得推广。

Objective To investigate the efficacy and safety of raltitrexed combined with oxaliplatin and 5-fluorouracil leucovorin combined with oxaliplatin in the treatment of advanced colorectal cancer. Method A total of 104 patients with advanced colorectal cancer admitted in Hangzhou Cancer Hospital from September 2014 to August 2016 were randomly divided into two groups according to the principle of random assignment. The patients in the control group were treated with 5-fluorouracil leucovorin and oxaliplatin, and the patients in the observation group were treated with raltitrexed and oxaliplatin, and the clinical therapeutic effect, adverse reaction and quality of life were observed. Result The clinical effective rate and disease control rate were 36.54% and 78.85% in the observation group and 34.62% and 75.0% respectively in the control group. There was no significant difference between the two groups （P〉0.05）. The patients with leukopenia, anemia, nausea, vomiting, hyperbilirubinemia, diarrhea, stomatitis and alopecia were significantly lower than those of the control group （P〈0.05）. After treatment, the physical function, physical function, psychological function and social function score of the observation group were significantly higher than those of the control group （P〈0.05）. Conclusion In the clinical treatment of advanced colorectal cancer, raltitrexed combined with oxaliplatin and 5-fluorouracil leucovorin combined with oxaliplatin can get the ideal therapeutic effect, but the combination of raltitrexed and O＆#39;Sullivan Platinum treatment program is more prominent, less adverse reactions, high quality of life, worthy of promotion.