结直肠癌患者对含奥沙利铂辅助化疗的耐受性  

Tolerability of Oxalipltin-based Adjuvant Chemotherapy in Colorectal Cancer Patients

作　　者：杨林[1] 王金万[1] 崔成旭[1] 张弘刚[1] 李玉升[1] 黄镜[1] 周爱萍[1] 依荷芭丽.迟 石远凯[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所内科,100021

出　　处：《肿瘤防治研究》2008年第12期892-896,共5页Cancer Research on Prevention and Treatment

摘　　要：目的对结直肠癌根治术后接受含奥沙利铂(LOHP)辅助化疗患者的耐受性进行评价。方法对2001年11月～2008年1月在我院接受含LOHP方案辅助化疗的250例患者的临床资料进行回顾性分析。包括三种化疗方案:LOHP联合持续灌注5氟尿嘧啶(5-Fu)和甲酰四氢叶酸钙(LV)的两周方案(FOLFOX4)、LOHP联合快速输注5-Fu和LV的三周方案(LOHP/Fu/LV)、LOHP联合口服卡培他滨的三周方案(XELOX)。结果三种方案LOHP的相对剂量强度分别为99.4%、93.3%、100.5%。中位完成治疗周期数分别为8、6、6周期。不能耐受不良反应是患者提前终止治疗的主要原因。恶心(88.8%)、呕吐(45.6%)和外周神经毒性(71.2%)、中性粒细胞下降(38%)和血小板下降(55.6%)是最常见的不良反应。直肠癌患者与结肠癌相比,除了贫血的发生率稍高外,其他不良反应两组之间无明显差别。结论本组患者对含奥沙利铂方案辅助化疗的耐受性较西方人差。疗效是否有差异还需等待生存的随访结果。Objective To analyze the tolerability of oxaliplatin-based adjuvant chemotherapy in colorectal cancer patients. Methods Clinical data of 250 patients who had received oxaliplatin-based adjuvant chemotherapy from November 2001 to January 2008 in our hospital were analyzed retrospectively. There were three different chemotherapy regimens. Bi-weekly oxaliplatin combined with continuous intravenous in fused 5 fluorouracil （5 Fu） and leucovorin （LV） （FOLFOX4） ,tri-weekly oxaliplatin combined with bolus 5 Fu and LV（LOHP/Fu/LV） or orally capecitabine （XELOX）. Results Relative dose intensity of oxaliplatin were 99. 4%,93.3% and 100. 5% respectively in these three regimens. The median number of completed treatment cycles were 8,6 and 6. The most common cause for withdrawing from treatment early was to be unable to tolerate the adverse effects （AEs）. Nausea （88. 8% ）, vomiting （45.6 %）, neuropathy（71.2 % ）, neutropenia （38 % ）and thrombocytopenia（55.6 % ） were the most frequent grade 3 or 4 AEs. Anaemia was more common in rectal cancer patients than in colon cancer patients. Conclusion Patients in our hospital who received oxaliplatin based adjuvant chemotherapy were less tolerable than in western countries. It is necessary to us to expect the survival data to show if there are any difference between our patients and westerns.

关 键 词：结直肠癌 辅助化疗 奥沙利铂 5氟尿嘧啶 耐受性 

分 类 号：R730.53[医药卫生—肿瘤] R735.3[医药卫生—临床医学]