雷替曲塞联合奥沙利铂在结直肠癌一线治疗失败后的临床应用  

The clinical application of raltitrexed and oxaliplatin as first-line chemotherapy for advanced colorectal cancer

作　　者：宋文灿[1] 潘明[1] 徐金发[1] 郑中显[1] 

机构地区：[1]安徽省池州市人民医院肿瘤科,247000

出　　处：《安徽医学》2014年第5期641-644,共4页Anhui Medical Journal

摘　　要：目的评价雷替曲塞联合奥沙利铂(L-OHP)在结直肠癌一线治疗失败后的近期疗效和安全性。方法选取35例FOLFOX和(或)FOLFIRI方案治疗失败的结直肠癌患者,应用本方案治疗:雷替曲塞3 mg/m2,静脉滴注15 min,dl,奥沙利铂(LOHP)130 mg/m2,静脉滴注3 h,dl,避冷。患者均签署知情同意书,以21 d为1个周期,至少2个周期后评价一次疗效及安全性,病情进展或毒副作用不能耐受则终止该方案,最多治疗6周期。结果入组患者予雷替曲塞联合奥沙利铂治疗后客观有效率RR(CR+PR)为28.6%,DCR(CR+PR+SD)为71.4%;不良反应主要是转氨酶升高(48.6%)、末梢神经感觉异常(45.7%),消化道反应、骨髓抑制及脱发等发生率低,患者耐受性良好。结论结直肠癌经FOLFOX和(或)FOLFIRI方案治疗失败后予雷曲塞联合奥沙利铂方案治疗仍有效,无交叉耐药,使用方便,毒副作用可耐受,是值得推荐的治疗晚期结直肠癌的化疗方案。Objective To evaluate the efficacy and safety of raltitrexed and oxaliplatin (L-OHP)in colorectal cancer after failure of first-line treatment.Methods A total of 35 patients treated by raltitrexed and oxaliplatin who failed in FOLFOX and/or FOLFIRI of colorec-tal cancer received the treatment:raltitrexed 3mg/m2 ivgtt 15min,d1;oxaliplatin 130mg/m2 ivgtt 3h,d1,avoided coldness.Informed consent form was signed by all patients.The program was 21 days as a cycle,and a total of six cycles was applied unless there was evidence of disease progression or unacceptable toxicity.The efficacy was evaluated after 2-cycle chemotherapy.Results The objective response rate of treatment RR(CR+PR)raltitrexed combined with oxaliplatin was 28.6%,and DCR(CR+PR+SD)was 71.4%.The main side effects were elevated transaminase (48.6%)and peripheral sensory neuropathy (45.7%).Gastrointestinal reactions,bone marrow suppression,hair loss and so on had low incidence,which could basically be tolerated.Conclusion The program of combining roaltitrexed with oxaliplatin is still valid when failed by FOLFOX and /or FOLFIRI in colorectal cancer.It has no cross-resistance,is easy to use,and the side effects can be tolerated,so it may be recommended as a treatment of advanced colorectal cancer chemotherapy.

关 键 词：雷替曲塞 奥沙利铂 结直肠癌 

分 类 号：R735.34[医药卫生—肿瘤]