雷替曲塞及其联合奥沙利铂或伊立替康治疗晚期结直肠癌对转氨酶的影响

Effect of raltitrexeds combined with oxaliplatin or irinotecan on transaminase in patient with advanced colorectal cancer

目的:探讨雷替曲塞单药方案、雷替曲塞联合奥沙利铂或伊立替康方案在二线治疗晚期结直肠癌过程中对转氨酶的影响。方法:收集晚期结直肠癌病人48例,按照化疗方案分为3组:A组13例,采用雷替曲塞单药化疗方案;B组23例,采用雷替曲塞联合奥沙利铂化疗方案;C组12例,采用雷替曲塞联合伊立替康化疗方案。比较3种方案在晚期结直肠癌病人化疗过程中对天冬氨酸氨基转移酶(AST)和丙氨酸氨基转移酶(ALT)的影响。结果:3组病人均经过3个及以上化疗周期,A、B、C组病人AST处于正常值范围比例分别为53.85%、86.96%、83.33%,ALT处于正常值范围比例分别为92.31%、91.30%、100%,3组AST和ALT分级差异均无统计学意义(P>0.05)。3组肝转移病人ALT差异无统计学意义(P>0.05),C组AST均高于A组和B组(P<0.01和P<0.05);无肝转移病人中,B组和C组AST和ALT均低于A组(P<0.05~P<0.01)。3组不同原发病灶病人AST和ALT间差异均无统计学意义(P>0.05)。结论:以雷替曲塞为基础的二线治疗方案,可作为晚期结直肠癌病人有效的姑息治疗方案,值得推广。

Objective:To investigate the effects of raltitrexed,and raltitrexed combined with oxaliplatin or irinotecan on transaminase in patients with advanced colorectal cancer. Methods:Forty-eight patients with advanced colorectal cancer were divided into group A(13 case) group B(23 cases) and group C(12 cases) according to the chemotherapy regimen.The A group,B group and C group were treated with raltitrexed monotherapy,chemotherapy of raltitrexed combined with oxaliplatin and raltitrexed combined with irinotecan,respectively.The effects of three regimens on the levels of AST and ALT in patients with advanced colorectal cancer were analyzed. Results:After three groups were treated with three or more cycles of chemotherapy,the proportions of AST in normal range in group A,B and C were 53.85%,86.96% and 83.33%,respectively,the proportions of ALT in normal range in group A,B and C were 92.31%,91.30% and 100%,respectively,and the differences of the AST and ALT grading among three groups were not statistically significant( P >0.05).The differences of the ALT in patients with liver metastasis among three groups were not statistically significant( P >0.05),and the level of AST in group C were higher than that in group A and group B( P <0.01 and P <0.05).The levels of AST and ALT in patients without liver metastasis of group B and group C were lower than those of group A( P <0.05 to P <0.01).The differences of the ALT and AST in patients with different primary lesions among three groups were not statistically significant( P > 0.05 ). Conclusions:The raltitrexed-based second-line treatment can be used as an effective palliative treatment in patients with advanced colorectal cancer,which is worthy of further promotion.