雷替曲塞或氟尿嘧啶、亚叶酸钙联合奥沙利铂治疗转移性结直肠癌的疗效比较  

Clinical Study of Ralitrexed plus Oxaliplatin versus Fluorouracil and Leucovorin plus Oxaliplatin for Advanced Colorectal Cancer

作　　者：郭晶晶[1] 郑勤[1] 王立玮[1] 

机构地区：[1]南京市第二医院肿瘤科,210003

出　　处：《实用癌症杂志》2013年第5期518-520,537,共4页The Practical Journal of Cancer

摘　　要：目的比较雷替曲塞联合奥沙利铂(L-OHP)与氟尿嘧啶(5-Fu)、亚叶酸钙(Lv)联合奥沙利铂治疗转移性结直肠癌的疗效和安全性。方法回顾性分析58例转移性的结直肠癌患者治疗情况,其中雷替曲塞+L-OHP组28例,具体为:雷替曲塞3 mg/m2静脉滴注,第1天;奥沙利铂130 mg/m2静脉滴注,第1天,3周为1个周期。5-Fu+CF+LOHP组30例,具体为:亚叶酸钙200 mg/m2静脉滴注,第1～5天;氟尿嘧啶375 mg/m2静脉滴注,第1～5天;奥沙利铂130 mg/m2静脉滴注,第1天,3周为1个周期。结果雷替曲塞+L-OHP组和5-Fu+CF+L-OHP组的有效率分别为28.6%和16.7%(P=0.277),临床收益率分别为71.4%和70.0%(P>0.05),中位肿瘤进展时间分别为8.4个月和6.9个月(P=0.049)。2组发生不良反应主要为恶心呕吐、腹泻、神经病变、贫血、中性粒细胞减少、发热及感染等,差异无统计学意义。结论雷替曲塞联合奥沙利铂较传统的氟尿嘧啶、亚叶酸钙联合奥沙利铂治疗晚期复发转移性结直肠癌,可延长无进展生存时间,值得临床进一步研究。Objective To evaluate the efficacy and toxicity of oxaliplatin plus raltitrexed versus oxaliplatin plus fluorou- racil and leueovorin for patients with advanced colorectal cancer. Methods 58 patients with advanced colorectal cancer were di- vided into 2 groups ： Group oxaliplatin ＋ raltitrexed with 28 patients （ raltitrexed 3 mg/m2 ivgtt, dl ; oxaliplatin 130 mg/m2 ivgtt, dl. 3 weeks a cycle） and Group oxaliplatin ＋ leueovorin ＋ fluorouracil with 30 patients （ leucovorin 200 mg/m2 ivgtt, d1 - d5 ; flu- orouraeil 375 mg/m2 ivgtt, d1 - d3 ;oxaliplatin 130 mg/m2 ivgtt, dl. 3 weeks a cycle）. Results In Group oxaliplatin ＋ raltitrexed and Group oxaliplatin ＋ leueovorin ＋ fluorouracil, the response rate was 28.6% and 16.7% （P = 0.277 ）, the disease control rate was 71.4% and 70.0% （ P 〉 0.05）, the median time to progress was 8.4 months and 6.9 months （ P = 0. 049）, respectively. Main side effects of both groups were vomiting,neutrocytopenia, thrombocyto-penia, nausea, fever and infection,which were com- parable between the 2 groups （P 〉 0.05）. Conclusion The benefit of oxaliplatin plus rahitrexed regimen is over oxaliplatin plus leueovorin and fluorouracil in the time to progress in patients with advanced colorectal cancer. These results indicate that further clinical study is of great value.

关 键 词：结直肠癌 化学治疗 雷替曲塞 奥沙利铂 氟尿嘧啶 

分 类 号：R735.3[医药卫生—肿瘤]