雷替曲塞联合奥沙利铂与FOLFOX 4方案治疗中晚期原发性肝癌的疗效评价  

Clinical efficacy of raltitrexed combined with oxaliplatin and FOLFOX 4 protocol in treatment of patients with middle and advanced primary liver cancer

作　　者：沈永奇[1] 黄军[2] 陈超庭[3] 斯韬[4] 王志祥[5] 谢华东 孔祥应[2] 刘金娥[1] 韩朝稳 

机构地区：[1]广西医科大学附属柳铁中心医院肿瘤科,广西柳州545007 [2]贵阳中医学院第三附属医院肿瘤科,贵州都匀558004 [3]广西科技大学第二附属医院化疗二科,广西柳州545006 [4]广西中医药大学第三附属医院肿瘤二科,广西柳州545001 [5]广西中医药大学第三附属医院肿瘤一科,广西柳州545001 [6]广西壮族自治区柳州市融水县人民医院肿瘤科,广西柳州545300

出　　处：《实用临床医药杂志》2017年第7期39-42,46,共5页Journal of Clinical Medicine in Practice

基　　金：广西壮族自治区卫计委科研项目(Z2014408);广西壮族自治区柳州市科技攻关项目(2014J030424)

摘　　要：目的探讨雷替曲塞联合奥沙利铂(RALOX方案)与5-氟尿嘧啶+亚叶酸钙+奥沙利铂(FOLFOX 4方案)对中晚期原发性肝癌(PLC)的疗效及药物毒性反应。方法选取72例中晚期PLC患者,随机分为RALOX组(n=34)与FOLFOX 4组(n=38)。化疗后每6周评价客观疗效,观察客观缓解率(OR)、疾病控制率(DCR)、中位生存期(mOS)、中位无进展生存期(mPFS)、1年存活率(SR)及毒副反应。结果 RALOX组可评价31例,OR为19.4%,DCR为51.6%,mOS为7.2个月,mPFS为3.4个月,1年SR为22.6%;FOLFOX 4方案组可评价29例,OR为13.8%,DCR为48.3%,mOS为6.9个月,mPFS为3.3个月,1年SR为20.7%,2组差异无有统计学意义(P>0.05)。RALOX组消化道反应、肝毒性、心脏毒性、外周神经毒性及手足综合征的发生率均低于FOLFOX 4组,肾毒性、骨髓抑制的发生率2组相当。结论 RALOX方案应用于中晚期PLC患者安全有效,疗效不劣于FOLFOX 4方案且副反应较轻。Objective To explore the clinical efficacy and drug-toxic reactions of raltitrexed combined with oxaliplatin （RALOX protocol） and 5- fluorouracil ＋ calciumfolinate ＋ oxaliplatin （ FOLFOX 4 protocol ） in the treatment of patients with middle and advanced primary liver cancer（PLC）. Methods A total of 72 patients with PLC were selected and randomly divided into RALOX group （ n = 34） and FOLFOX 4 group （ n = 38 ）. The objective response rate （RR） was evaluated every 6 weeks after chemotherapy, while objective remission rate （OR）, disease-control rate （DCR） , median survival rate （mOS） , median progression-free survival （mPFS） , 1-year survival rate （SR） as well as toxic and adverse reactions were observed. Results In RALOX group, 31 pa- tients were evaluable, with OR, DCR, mOS, mPFS, and 1-year SR being 19.4%, 51.6% , 7.2 months, 3.4 months, and 22.6%, respectively. In FOLFOX 4 group, 29 patients with OR, DCR, mOS, mPFS, and 1-year SR being 13.8%, 48.3%, 6.9 months, were evaluable, 3.3 months and 20.7%, respectively. RALOX group was significantly lower than FOLFOX 4 group in the incidence rates of gastrointestinal reactions, liver toxicity, cardiac toxicity, peripheral nervous toxicity and hand-foot syndrome, but there were no significant differences in the incidence rates of renal toxicity and myelosuppression between two groups. Conclusion RALOX is safe and effective in the treat- ment of patients with middle and advanced PLC, and is superior to FOLFOX 4 protocol in clinical efficacy with mild adverse reactions.

关 键 词：原发性肝癌 奥沙利铂 雷替曲塞 FOLFOX 4方案 化疗 

分 类 号：R735.7[医药卫生—肿瘤]