中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
4期
7-10
,共4页
薛红健%樊继全%曹如波%朱芳%姚静
薛紅健%樊繼全%曹如波%硃芳%姚靜
설홍건%번계전%조여파%주방%요정
结直肠肿瘤%前瞻性研究%抗肿瘤联合化疗方案%雷替曲塞
結直腸腫瘤%前瞻性研究%抗腫瘤聯閤化療方案%雷替麯塞
결직장종류%전첨성연구%항종류연합화료방안%뢰체곡새
Colorectal neoplasms%Prospective studies%Antineoplastic combined chemotherapy protocols%Raltitrexed
目的 前瞻性比较雷替曲塞对比氟尿嘧啶(FU)/亚叶酸钙(LV)联合奥沙利铂治疗晚期结直肠癌的疗效和安全性.方法 经病理组织学和/或细胞学确诊的晚期结直肠癌患者50例,随机分组信件形式进入试验组和对照组,每组25例,各脱落1例.试验组:雷替曲塞3 mg/m2,静脉滴注≥15min,第1天;奥沙利铂130mg/m2,静脉滴注2 h,第1天.对照组:LV 100mg/m2,静脉滴注2h,第1～3天;FU 400mg/m2,静脉滴注2 h;紧接FU 600mg/m2,持续静脉滴注,第1～3天;奥沙利铂同试验组.两组方案均为每3周重复,每3周为1个周期.每2个周期评价疗效,直至疾病进展或不良反应不能耐受,最多用6个周期.结果 试验组和对照组的有效率分别为37.50%(9/24)、33.33%(8/24),差异无统计学意义(P＞0.05);疾病控制率分别为83.33%(20/24)和70.83%(17/24),差异无统计学意义(P＞0.05).试验组中位无疾病进展时间11.0个月,明显优于对照组的9.0个月(95%CI8.643～11.357,P=0.015).主要不良反应包括食欲减退、呕吐、中性粒细胞减少、红细胞减少、血小板减少、神经毒性、疲劳、转氨酶异常等,两组比较差异无统计学意义(P＞0.05).结论 雷替曲塞联合奥沙利铂方案是晚期结直肠癌有效的治疗方案,较传统的以FU为基础的联合化疗方案使用方便,减少静脉暴露时间,缩短住院时间,并且在有效率、生存期方面优于或不劣于以FU为基础的联合化疗,是值得推荐的治疗晚期结直肠癌的化疗方案.
目的 前瞻性比較雷替麯塞對比氟尿嘧啶(FU)/亞葉痠鈣(LV)聯閤奧沙利鉑治療晚期結直腸癌的療效和安全性.方法 經病理組織學和/或細胞學確診的晚期結直腸癌患者50例,隨機分組信件形式進入試驗組和對照組,每組25例,各脫落1例.試驗組:雷替麯塞3 mg/m2,靜脈滴註≥15min,第1天;奧沙利鉑130mg/m2,靜脈滴註2 h,第1天.對照組:LV 100mg/m2,靜脈滴註2h,第1～3天;FU 400mg/m2,靜脈滴註2 h;緊接FU 600mg/m2,持續靜脈滴註,第1～3天;奧沙利鉑同試驗組.兩組方案均為每3週重複,每3週為1箇週期.每2箇週期評價療效,直至疾病進展或不良反應不能耐受,最多用6箇週期.結果 試驗組和對照組的有效率分彆為37.50%(9/24)、33.33%(8/24),差異無統計學意義(P＞0.05);疾病控製率分彆為83.33%(20/24)和70.83%(17/24),差異無統計學意義(P＞0.05).試驗組中位無疾病進展時間11.0箇月,明顯優于對照組的9.0箇月(95%CI8.643～11.357,P=0.015).主要不良反應包括食欲減退、嘔吐、中性粒細胞減少、紅細胞減少、血小闆減少、神經毒性、疲勞、轉氨酶異常等,兩組比較差異無統計學意義(P＞0.05).結論 雷替麯塞聯閤奧沙利鉑方案是晚期結直腸癌有效的治療方案,較傳統的以FU為基礎的聯閤化療方案使用方便,減少靜脈暴露時間,縮短住院時間,併且在有效率、生存期方麵優于或不劣于以FU為基礎的聯閤化療,是值得推薦的治療晚期結直腸癌的化療方案.
목적 전첨성비교뢰체곡새대비불뇨밀정(FU)/아협산개(LV)연합오사리박치료만기결직장암적료효화안전성.방법 경병리조직학화/혹세포학학진적만기결직장암환자50례,수궤분조신건형식진입시험조화대조조,매조25례,각탈락1례.시험조:뢰체곡새3 mg/m2,정맥적주≥15min,제1천;오사리박130mg/m2,정맥적주2 h,제1천.대조조:LV 100mg/m2,정맥적주2h,제1～3천;FU 400mg/m2,정맥적주2 h;긴접FU 600mg/m2,지속정맥적주,제1～3천;오사리박동시험조.량조방안균위매3주중복,매3주위1개주기.매2개주기평개료효,직지질병진전혹불량반응불능내수,최다용6개주기.결과 시험조화대조조적유효솔분별위37.50%(9/24)、33.33%(8/24),차이무통계학의의(P＞0.05);질병공제솔분별위83.33%(20/24)화70.83%(17/24),차이무통계학의의(P＞0.05).시험조중위무질병진전시간11.0개월,명현우우대조조적9.0개월(95%CI8.643～11.357,P=0.015).주요불량반응포괄식욕감퇴、구토、중성립세포감소、홍세포감소、혈소판감소、신경독성、피로、전안매이상등,량조비교차이무통계학의의(P＞0.05).결론 뢰체곡새연합오사리박방안시만기결직장암유효적치료방안,교전통적이FU위기출적연합화료방안사용방편,감소정맥폭로시간,축단주원시간,병차재유효솔、생존기방면우우혹불렬우이FU위기출적연합화료,시치득추천적치료만기결직장암적화료방안.
Objective To compare the effectiveness and safety of raltitrexed and fluorouracil(FU)/leucovorin (LV) combined with oxaliplatin for advanced colorectal cancer. Methods Fifty patients with advanced colorectal cancer diagnosed by histopathology or cytology were randomly divided into two groups with 25 cases each by envelope, but 1 case lost. Patients in experimental group were treated with raltitrexed (3 mg/m2, ≥ 15 min intravenously) combined with oxaliplatin (130 mg/m2 on day 1 ), patients in control group were treated with FU/LV combined with oxaliplatin:LV 100 mg/m2 infusion (over 2 h, from day 1 to day 3 ) followed by FU (400 mg/m2 infusion in 2 h and 600 mg/m2 continuous infusion from day 1 to day 3 ),combined with oxaliplatin ( 130 mg/m2 on day 1 ), 3 weeks were as one cycle. Patients received 6 or less cycles until disease progressed or toxicity could not be tolerated. Results Effective rate was 37.50%(9/24)and 33.33%(8/24) in experimental group and control group respectively (P＞ 0.05). Disease control rate in experimental group was 83.33% (20/24) while in control group was 70.83% ( 17/24 ) (P ＞ 0.05 ). The median time of progression-free survival (PFS) in experimental group and control group was 11.0 months and 9.0 months respectively (95%CI 8.643-11.357,P =0.015). Main adverse effects were anorexia, vomiting, neutropenia, thrombopenia, anemia, neurotoxicity, fatigue, aminotransferase abnormality, and so on. There was no statistic difference between two groups in side effects(P ＞ 0.05). Conclusions Raltitrexed combined with oxaliplatin is an effective regimen for the advanced colorectal cancer. Compared with traditional FU-based regimen, it is more convenient. Patients will have less venous exposure time and hospital days.Effective rate and mean survival time are superior or not inferior in raltitrexed treatment to that of FU-based regimen. Raltitrexed combined with oxaliplatin is worthy to be recommended in treating colorectal cancer.
