CAJ | 학술논문

目的：探讨雷替曲塞以腹腔／静脉给药途径治疗结直肠癌腹水的疗效。方法经病理或细胞学确诊的50例晚期结直肠癌腹水患者分为观察组（ n＝25）和对照组（ n＝25）。观察组方案：雷替曲塞3 mg／m2腹腔灌注，奥沙利铂120 mg／m2静滴。对照组方案：雷替曲塞3 mg／m2静滴，奥沙利铂120 mg／m2静滴。两方案均3周为1周期，每周期评价不良反应，每3个周期评价疗效，直至疾病进展或毒性不能耐受，最多治疗12个周期，比较两组的有效率（ RR）、疾病控制率（ DCR）、中位肿瘤进展时间（mTTP）及不良反应发生率。结果两组RR分别为20％和8％（P＜0．05），DCR分别为92％和84％（P＞0．05）及mTTP分别为4．5个月和3．6个月（P＜0．05）。观察组1、2级丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）升高发生率为4％，对照组为24％（P＜0．05）；对照组1、2级中性粒细胞减少、口腔黏膜炎的发生率（分别为48％与32％），均高于观察组（20％与8％）（P＜0．05）。结论雷替曲塞腹腔给药疗效优于静脉给药，不良反应更轻，可以作为结直肠癌晚期腹水的有效姑息治疗方案。
목적：탐토뢰체곡새이복강／정맥급약도경치료결직장암복수적료효。방법경병리혹세포학학진적50례만기결직장암복수환자분위관찰조（ n＝25）화대조조（ n＝25）。관찰조방안：뢰체곡새3 mg／m2복강관주，오사리박120 mg／m2정적。대조조방안：뢰체곡새3 mg／m2정적，오사리박120 mg／m2정적。량방안균3주위1주기，매주기평개불량반응，매3개주기평개료효，직지질병진전혹독성불능내수，최다치료12개주기，비교량조적유효솔（ RR）、질병공제솔（ DCR）、중위종류진전시간（mTTP）급불량반응발생솔。결과량조RR분별위20％화8％（P＜0．05），DCR분별위92％화84％（P＞0．05）급mTTP분별위4．5개월화3．6개월（P＜0．05）。관찰조1、2급병안산안기전이매（ALT）화천동안산안기전이매（AST）승고발생솔위4％，대조조위24％（P＜0．05）；대조조1、2급중성립세포감소、구강점막염적발생솔（분별위48％여32％），균고우관찰조（20％여8％）（P＜0．05）。결론뢰체곡새복강급약료효우우정맥급약，불량반응경경，가이작위결직장암만기복수적유효고식치료방안。
Objective To investigate the effect in peritoneal/intravenous route of administration for the treatment of colorectal cancer ascites by raltitrexed .Methods There were histologically or cytologically diagnosed 50 cases of advanced colorectal cancer pa-tients with ascites , which were divided into the trial group ( n=25 ) and the control group ( n=25 ) .The trial group: raltitrexed 3 mg/m2 intraperitoneal perfusion , oxaliplatin intravenous infusion of 120 mg/m2 , the first day.The control group: raltitrexed intrave-nous infusion of 3 mg/m2 .Oxaliplatin intravenous infusion of 120 mg/m2 , the first day.The two group were 3 weeks for 1 cycles, and toxicity and curative effect were evaluated every cycle and every 3 cycles until disease progression or intolerant toxicity .The maximum was 12 cycles of treatment .To compared response rate ( RR) , disease control rate ( DCR) , the median progression ( mTTP) and ad-verse effects rate of two groups.Results RR of two groups was 20%and 8%(P<0.05), DCR was 92%and 84%(P>0.05) and mTTP was 4.5 months and 3.6 months (P<0.05).1, 2 level incidence of ALT (alanine aminotransferase) and AST (aspartate ami-notransferase ) of the trial group was 4%, lower than 24%of the control group ( P<0.05);1, 2 level neutropenia and mucositis inci-dence rates of the control group were 48%and 32%,the rates of the trial group were 20%and 8%,the rates of the control group were higher than that of the trial group (P<0.05).Conclusion The effect of raltitrexed celiac injection was better than intravenous ad-ministration , and toxicity was lighter , so it can be used as an effective palliative treatment options for metastatic colorectal cancer in ad -vanced ascites .