雷替曲塞联合伊立替康二线治疗晚期结直肠癌疗效及安全性观察

Observation on efficacy and safety of Raltitrexed combined with Irinotecan as the second-line treatment of advanced colorectal cancer

目的观察雷替曲塞联合伊立替康二线治疗晚期结直肠癌疗效和安全性。方法46例一线化疗失败的晚期结直肠癌患者,随机分为治疗组(24例)与对照组(22例)。治疗组采用雷替曲塞联合伊立替康治疗,对照组采用伊立替康联合5-氟尿嘧啶(5-FU)治疗。比较两组临床疗效及不良反应发生情况。结果治疗组有效率(RR)为45.8%,高于对照组的18.2%,差异具有统计学意义(P<0.05)。两组疾病控制率(DCR)比较差异无统计学意义(P>0.05)。两组大多数不良反应为Ⅰ~Ⅱ度,无治疗相关死亡病例。治疗组恶心呕吐、黏膜炎发生率分别为25.0%、20.8%,均明显低于对照组的68.2%、45.5%,差异有统计学意义(P<0.05);两组患者骨髓抑制、腹泻、转氨酶升高、疲乏、胆碱能综合征等发生率比较,差异无统计学意义(P>0.05)。结论雷替曲塞联合伊立替康二线治疗晚期结直肠癌,疗效肯定,副作用较少。此方案可作为晚期结直肠癌一线FOLFOX方案治疗失败后的二线治疗的选择。

Objective To observe the efficacy and safety of Raltitrexed combined with Irinotecan as the second-line treatment of advanced colorectal cancer.Methods A total of 46 cases of advanced colorectal cancer patients who failed first-line chemotherapy were randomly divided into treatment group(24 cases)and control group(22 cases).The treatment group was treated with Raltitrexed combined with Irinotecan,and the control group was treated with Irinotecan combined with 5-fluorouracil(5-FU).The clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results The response rate(RR)of the treatment group was 45.8%,which was higher than 18.2%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in disease control rate(DCR)between the two groups(P>0.05).Most of the adverse reactions in the two groups were grade I-II,and there were no treatment-related deaths.The incidence of nausea and vomiting and mucositis of the treatment group were 25.%and 20.8%,which were obviously lower than 68.2%and 45.5%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in incidence of myelosuppression,diarrhea,elevated transaminase,fatigue and cholinergic syndrome between the two groups(P>0.05).Conclusion Raltitrexed combined with irinotecan as the second-line treatment of advanced colorectal cancer has a positive effect and fewer side effects.This regimen can be used as a second-line treatment option after the failure of the first-line FOLFOX regimen for advanced colorectal cancer.