不同剂量阿司匹林对改善晚期化疗后结直肠癌患者预后的影响

Effect of different doses of Aspirin combined with chemotherapy on prognosis of patients with advanced colorectal cancer

目的探讨不同剂量阿司匹林对改善晚期化疗后结直肠癌患者预后的影响。方法选取2012年1月～2013年4月柳州市人民医院收治的晚期结直肠癌患者80例,根据阿司匹林的使用剂量分为低剂量组(40例)和高剂量组(40例)。低剂量组患者在化疗后给予阿司匹林100 mg/d,高剂量组在化疗后给予阿司匹林200 mg/d。比较两组患者治疗后总有效率,记录两组患者无进展生存时间(PFS)、3年总生存率(OS)、5年OS,比较两组患者治疗前后血清肿瘤标志物水平,治疗期间不良反应发生情况。结果高剂量组总有效率、疾病控制率显著高于低剂量组,差异有统计学意义(P <0.05)。两组患者治疗后血清CA199、CEA均降低,且高剂量组低于低剂量组,差异有统计学意义(P <0.05)。高剂量组患者PFS、3年OS、5年OS均显著高于低剂量组患者,差异有统计学意义(P <0.05)。高剂量组不良反应总发生率高于低剂量组,差异有统计学意义(P <0.05)。结论晚期结直肠癌患者化疗后给予高剂量阿司匹林治疗,疗效较佳,可明显降低血清肿瘤标志物水平,提高患者生存率,但不良反应较多,临床可视患者具体情况选择剂量。

Objective To investigate the effect of different doses of Aspirin combined with chemotherapy on the prognosis of patients with advanced colorectal cancer. Methods From January 2012 to April 2013, in Liuzhou People′s Hospital, 80 patients with advanced colorectal cancer were selected, they were divided into low dose group (40 cases) and high dose group (40 cases), low dose group was given Aspirin 100 mg/d after chemotherapy, and high dose group was given Aspirin 200 mg/d after chemotherapy. The total effective rate of the two groups after treatment was compared, the progression-free survival time (PFS), 3-year overall survival rate (OS) and 5-year OS of the two groups was recorded. The serum tumor marker before and after treatment was compared, and the adverse reaction was recorded. Results Total effective rate and disease control rate in high dose group were significantly higher than low dose group, the differences were statistically significant (P < 0.05). After treatment, serum CA199 and CEA of two groups were lower than before treatment, and these of the high dose group were lower than low dose group, the differences were statistically significant (P < 0.05). PFS, 3-year OS and 5-year OS in high dose group were significantly higher than low dose group, the differences were statistically significant (P < 0.05). The total incidence of adverse reactions in high dose group was higher than low dose group, the difference was statistically significant (P < 0.05). Conclusion High dose aspirin therapy for advanced colorectal cancer patients after chemotherapy has a better curative effect, it can significantly reduce the level of serum tumor markers, improve the survival rate of patients, but there are many adverse reactions, clinical patients can choose the dose according to the specific circumstances.