Capox方案联合阿司匹林治疗老年转移性结肠癌的临床观察  

The Capox regimen combined with low-dose aspirin in elderly patients with metastatic colon cancer

作　　者：左新年[1] 丁江华[2] 邹国辉[1] 

机构地区：[1]解放军第171医院消化科,江西九江332000 [2]解放军第171医院肿瘤科,江西九江332000

出　　处：《中华临床医师杂志（电子版）》2013年第6期74-76,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨在转移性结肠癌中低剂量阿司匹林(ASA)与Capox方案联合时增效作用。方法选择54例无出血倾向的老年转移性结肠癌患者,随机分成2组:Capox方案组与Capox联合ASA组。28例Capox方案组病例单纯接受化疗:卡培他滨1000mg·(m2)-1·d-1,d1～14,每日2次,口服,第1～14天;奥沙利铂130mg/m2,静脉滴注,第1天。每3周为1周期。26例Capox联合ASA组接受化疗外,于化疗期及化疗间歇期均持续口服阿司匹林75mg/d,同时口服奥美拉唑20mg/d保护胃黏膜。结果 (1)Capox+ASA组与Capox组客观有效率(OR)无差异(57.6%vs.46.4%,P>0.05),但Capox+ASA组疾病控制率(DCR)显著高于Capox组(92.3%vs.67.8%,P<0.05);(2)Capox+ASA组1年、3年生存率均显著高于Ca-pox组(84.6%vs.67.8%;46.2%vs.28.6%,P均<0.05)。(3)毒副反应包括神经毒性、白细胞减少、恶心呕吐与手足综合征等,四者发生率在Capox+ASA组与Capox组无差异(P>0.05)。尽管两组手足综合征发生率无差别,但Capox+ASA组有低发生率趋势(7.6%vs.14.3%),未观察到消化道出血副作用。结论 Capox联合低剂量ASA治疗老年转移性结肠癌患者,可延长生存期、降低毒副反应,具有"减毒增效"的作用。Objective To investigate the synergistic effect of aspirin in combined with Capox regimen in patients with metastatic colon cancer （mCRC）.Methods 54 mCRC patients without haemorrhage tendency were divided randomly into two groups：the Capox regimen group received chemotherapy alone（i.e capecitabine 1000 mg/ m2 bid,d1-14 ;oxaliplatin,130 mg/m2,d1） ;the Capox regimen plus low-dose aspirin group receive chemotherapy and regular intake of aspirin（75 mg/d）,together with oral administration of omeprazole（20 mg/d）against gastric mucosal injury.Results （1） No significant difference in overall response rate （OR） was observed between the Capox group and the combined group （57.6％ vs.46.4％ P ＞ 0.05）.Higher disease-control rate （DCR） was found in the combined group when compared with the Capox group（92.3％ vs.67.8％,P ＜0.05）.（2） The 1-and 3-year survival rates of patients with mCRC in the combined group were markedly higher than that in the Capox group respectively （84.6％ vs.67.8％,46.2％ vs.28.6％ ;P ＜ 0.05）.（3） The common side-effects included neurotoxicity,leukocytes,nausea and vomiting,and hand-foot syndrome（HFS）.No statistical differences in the four side-effects existed between the two groups.However,the incidence of HFS in the combined group tended to decrease compared with the Capox group.No patients with mCRC in the combined group experienced the upper gastrointestinal bleeding.Conclusions The Capox regimen in combined with low-dose aspirin can prolong the survival in mCRC patients with lower incidence of HFS,indicating the improved effect and decreased toxicity.

关 键 词：结肠肿瘤 肿瘤转移 卡培他滨 奥沙利铂 阿司匹林 老年人 

分 类 号：R735.35[医药卫生—肿瘤]