雷替曲塞联合放疗辅助治疗Ⅱ、Ⅲ期直肠癌的可行性研究

Raltitrexed and radiotherapy as adjuvant treatment for atage Ⅱ-Ⅲ rectal cancer:a feasibility study

目的评价雷替曲塞联合放疗治疗直肠癌的可行性及胃肠道和血液学急性毒性反应。方法2013年6月—2017年6月,50例行根治性切除术的Ⅱ、Ⅲ期直肠腺癌伴局部复发高危因素的患者接受了雷替曲塞联合放疗。患者均接受了顺应性和急性毒性反应的评价,患者每周都进行临床评价和实验室检查,根据WHO标准评价毒性反应。结果 45例患者均完成了既定治疗,急性严重毒性包括3级直肠炎4/50(8%),3~4级腹泻4/50(8%),3级会阴部皮肤炎4/50(8%),3级白细胞减少2/50(4%),5例患者(10%)出现了3级肝脏功能的异常。结论本研究的急性毒性和患者依从性的数据证实了联合放化疗的可行性,但仍需进一步随访来评价该方案的有效率、无病生存率和总生存率。

Objective The aim of this study was to evaluate the feasibility of raltitrexed in combination with radiotherapy in rectal cancer patients,and the reaction of gastrointestinal tract and hematological acute toxicity.Methods From June 2013 to June 2017,50 patients suffered II,III stage rectal adenocarcinoma with high risk factors of local recurrence received raltitrexed combined with radiotherapy.The patients received an assessment of compliance and acute toxicity.The patients were evaluated and received laboratory tests weekly,and the toxicity was evaluated according to the WHO standard.Results All the 45 patients completed the planned treatment,acute toxicity including grade 3 severe proctitis（4/50,8%）,3-4 grade diarrhea（4/50,8%）,grade 3 perineal skin inflammation（4/50,8%）,grade 3 leukopenia（2/50,4%）,5 cases（10%） appeared level 3 abnormal liver function.Conclusions Our data related to acute toxicity and patient compliance proved the feasibility of this adjuvant radio-chemotherapy treatment.A longer follow-up is necessary to evaluate the effectiveness of this new regimen in terms of disease-free and overall survival.