不同原发部位结直肠癌伴转移患者的化疗效果观察

Primary tumor location and efficacy of chemotherapy in patients with metastatic colorectal cancer

目的探讨不同原发位置结直肠癌伴转移患者的化疗效果。方法选取2011年1月至2016年9月间泰州市人民医院收治的84例行一线化疗的结直肠癌伴转移的患者,按肿瘤原发位置分为回盲肠组11例,升结肠组15例,横结肠组9例,降结肠组20例,直肠组29例。比较各组患者采用不同化疗方案的临床疗效及总有效率。结果患者化疗总有效率为29.8%。原发于回盲部、升结肠、横结肠、降结肠和直肠的转移性大肠癌患者,化疗有效率分别为18.2%、26.7%、22.2%、40.0%和31.0%,各组间比较,差异有统计学意义(P<0.05)。不同原发位置患者接受以奥沙利铂和伊立替康为基础的化疗方案治疗,疗效之间比较,差异有统计学意义(P<0.05),接受氟尿嘧啶和亚叶酸钙化疗的不同原发位置患者的疗效比较,差异无统计学意义(P>0.05)。原发位置在横结肠的转移性大肠癌患者,接受以伊立替康为基础的化疗方案,疗效明显优于其余两种化疗方案,差异有统计学意义(P<0.05)。结论不同原发部位转移性结直肠癌一线化疗的疗效存在差异。

Objective To explored the influence of primary tumor location on the chemotherapy efficacy in patients with metastatic colorectal cancer. Methods Clinical data of 84 patients with metastatic colorectal cancer who received first-time chemotherapy at Taizhou People＇s Hospital from January 2011 to September 2016 were selected. According to primary tumor location,patients were divided into 5 groups： ileocecum group（ 11 patients）,ascending colon group（ 15 patients）,transverse colon group（ 9 patients）,descending colon group（ 20 patients） and rectum group（ 29 patients）. The efficacy of chemotherapy and overall efficacy rate between the five groups were compared by. Results The overall response rate was29. 8% for all 84 patients. The efficacy rate was 18. 2%,26. 7%,22. 2%,40. 0% and 31. 0%,respectively for patients with primary tumor located at ileocecum,ascending colon,transverse colon,descending colon and rectum（ P〈0. 05）. There were statistically significant differences in efficacy of oxaliplatin or irinotecan-based chemotherapy among different primary tumor location（ P〈0. 05） but no significant difference was found in efficacy of fluorouracil and calcium folinate（ P〈0. 05）. In patients with primary tumor located at transverse colon,irinotecan-based chemotherapy had higher ORR than the rest therapies（ P〈0. 05）.Conclusion First-line chemotherapy efficacy varies among different primary tumor sites in metastatic colorectal cancer.