改良CAPIRI与标准FOLFIRI方案二线治疗转移性结直肠癌的疗效与安全性分析  

Efficacy and safety of modified CAPIRI and standard FOLFIRI regimen for metastatic colorectal cancer

作　　者：王永辉[1] 韩传军 黄剑辉[1] 涂建飞[3] WANG Yong-hui;HAN Chuan-jun;HUANG Jian-hui;TU Jian-fei(Department of Oncology,Lishui Central Hospital,Lishui,Zhejiang 323000,China;不详)

机构地区：[1]丽水市中心医院肿瘤内科,浙江丽水323000 [2]六安市人民医院肿瘤内科,安徽六安237000 [3]丽水市中心医院介入科

出　　处：《中华全科医学》2020年第5期749-751,811,共4页Chinese Journal of General Practice

基　　金：国家卫生健康委员会科研基金(WKJ-ZJ-1932)。

摘　　要：目的对改良CAPIRI方案与标准FOLFIRI方案治疗转移性结直肠癌的临床疗效进行比较,分析其安全性。方法将2015年1月-2016年1月丽水市中心医院及六安市人民医院诊治的一线FOLFOX方案治疗失败的82例转移性结肠癌患者采用随机数字法分为改良CAPIRI组(40例)及标准FOLFIRI组(42例),对2组患者临床疗效及安全性进行比较。结果2组患者治疗前肿瘤标志物及生活质量评分差异无统计学意义,治疗后2组患者的CEA、CA199及AFP均较治疗前下降,但组间比较差异无统计学意义(均P>0.05);治疗后改良CAPIRI组患者的总体生活质量评分[(43.71±4.52)分]明显高于标准FOLFIRI组[(40.09±3.96)分,t=3.862,P<0.001];改良CAPIRI组患者的客观缓解率(ORR)及病情控制率(DCR)(20.00%、75.00%)与标准FOLFIRI组(23.81%、66.67%)相近(χ^2=0.174、0.687,P=0.677、0.408);改良CAPIRI组患者的中位总生存期(OS)及无进展生存期(PFS)与标准FOLFIRI组相近(Log Rankχ^2=0.621、0.206,P=0.431、0.650);但改良CAPIRI组患者不良反应总发生率及停药率(52.50%、0.00%)均明显低于FOLFIRI组(76.19%、9.52%,χ^2=5.030、4.005,P=0.025、0.045)。结论改良CAPIRI方案与标准FOLFIRI方案治疗转移性结肠癌的临床疗效相似,但不良反应较少,耐受度更好。Objective To compare the clinical efficacy of modified CAPIRI regimen with the standard FOLFIRI regimen in the treatment of metastatic colorectal cancer and to analyze its safety.Methods Patients with metastatic colon cancer who failed treatment with the first-line FOLFOX regimen from January 2015 to January 2016 were randomly assigned to the modified CAPIRI group and the standard FOLFIRI group.The clinical efficacy and safety between the two groups were compared.Results There were no significant differences between the two groups in pre-treatment tumor markers,and quality of life scores.CEA,CA199 and AFP in the modified CAPIRI group and the standard FOLFIRI group were lower than before,but there was no significant difference between the groups(all P>0.05).The overall quality of life scores of patients in the modified CAPIRI group[(43.71±4.52)scores]after treatment were significantly higher than those in the standard FOLFIRI group[(40.09±3.96)scores,t=3.862,P<0.001].The ORR and DCR(20.00%,75.00%)of patients with modified CAPIRI(23.81%,66.67%)were similar to those of the standard FOLFIRI group(χ^2=0.174,0.687;P=0.677,0.408).The median OS and PFS in the modified CAPIRI group were similar to the standard FOLFIRI group(Log Rankχ^2=0.621,0.206;P=0.431,0.650),but the total incidence of adverse reactions and drug withdrawal rate in the modified CAPIRI group(52.50%,0.00%),which were significantly lower than those in the FOLFIRI group(76.19%,9.52%;χ^2=5.030,4.005;P=0.025,0.045).Conclusion The improved CAPIRI regimen is similar to the standard FOLFIRI regimen in the treatment of metastatic colon cancer,but with fewer adverse effects and better tolerance.

关 键 词：改良CAPIRI方案 标准FOLFIRI方案 转移性结肠癌 生存分析 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]