阿司匹林维持治疗化疗后晚期结直肠癌的临床研究分析

Clinical Study of Aspirin Maintenance Treatment for Advanced Colorectal Cancer after Chemotherapy

目的探索阿司匹林维持治疗化疗后晚期结直肠癌患者的可行性、安全性和临床疗效。方法选择2014年至2017年柳州市人民医院接受姑息化疗的不能手术的晚期结直肠癌患者80例,随机分为观察组(40例)及对照组(40例)。观察组停止化疗后给予100mg/d阿司匹林治疗,对照组停止化疗后定期随访,评价有效率(RR)、疾病控制率(DCR)、无进展生存期(PFS)、生活质量评分(QOL)指标,并比较两组患者的临床疗效。结果观察组的RR为55.0%比对照组的32.5%高(P<0.05);而观察组的DCR为77.5%与对照组的57.5%无明显差别(P>0.05)。观察组QOL为(42.75±10.68)显著高于对照组(36.21±11.76),中位PFS为8.68个月显著高于对照组6.83个月,差异均有统计学意义(P<0.05)。结论小剂量(≤100mg/d)阿司匹林维持治疗可以有效提高化疗后晚期结直肠癌患者的RR,在一定程度上增加晚期结直肠癌患者的DCR,减少疾病恶化的可能性,在临床实践上具有一定的预防作用。

Objective To explore the feasibility,safety and clinical efficacy of aspirin in the maintenance treatment of advanced colorectal cancer after chemotherapy. Methods 80 inoperable patients with advanced colorectal cancer who received palliative chemotherapy in Liuzhou people's Hospital from 2014 to 2017 were randomly divided into experimental group(n=40) and control group(n=40).The experimental group was treated with 100mg/d aspirin after chemotherapy,while the control group was followed up regularly.The effective rate (RR),disease control rate (DCR),progression-free survival (PFS) and quality of life score (QOL) were evaluated.Also the clinical efficacy of the two groups were compared. Results RR was 55.0% in aspirin group and 32.5% in control group( P <0.05),while DCR in aspirin group was higher than that in control group (77.5% vs 57.5%, P >0.05).The QOL in aspirin group (42.75±10.68) was significantly higher than that of the control group (36.21±11.76),and the median PFS in aspirin group (8.68 months) was significantly higher than that of the control group (6.83 months)(all P <0.05). Conclusion Low-dose (≤100mg/d) aspirin maintenance therapy can effectively improve the RR of patients with advanced colorectal cancer after chemotherapy,increase the DCR to a certain extent and reduce the possibility of disease progression,and have a certain preventive effect in clinical practice.