雷替曲塞联合贝伐珠单抗治疗晚期结直肠癌的效果分析  

Effect of Raltitrexed Combined With Bevacizumab in the Treatment of Advanced Colorectal Cancer

作　　者：赵凯 张德均 李尚日[1] ZHAO Kai;ZHANG Deyun;LI Shangri(Department of Gastroenterology,the Second Hospital of Huangshi,Huangshi Hubei 435000,China;Center of Cancer,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430023,China)

机构地区：[1]黄石市第二医院消化内科,湖北黄石435000 [2]华中科技大学同济医学院附属协和医院肿瘤中心,湖北武汉430023

出　　处：《中国卫生标准管理》2022年第21期145-149,共5页China Health Standard Management

摘　　要：目的探讨卡培他滨与雷替曲塞分别联合贝伐珠单抗治疗晚期结直肠癌的临床效果。方法在2020年1月—2021年12月进修医院武汉协和医院肿瘤中心所收治的晚期结直肠癌患者中随机抽取100例作为本次的研究对象,利用抽签的方式进行不同组别的划分,抽中纸箱内蓝色卡片的50例患者作为对照组,抽中红色卡片的50例患者作为观察组,对照组患者治疗方法为卡培他滨联合贝伐珠单抗,观察组患者的治疗方法为雷替曲塞联合贝伐珠单抗治疗,两组均需治疗6周,并接受为期4个月的随访。对肿瘤客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)、无进展生存期(progression-free survival,PFS)、总生存期(overall survival,OS)以及不良反应发生率等指标进行对比分析。结果经过治疗后两组患者的ORR、DCR、PFS以及OS等指标对比差异无统计学意义(P>0.05),在治疗后,不同组别患者的不良反应发生率对比差异有统计学意义(P<0.05),即观察组患者Ⅰ~Ⅱ级周围神经毒性、恶心呕吐以及手足综合征发生率相较于对照组更低,差异有统计学意义(P<0.05);两组患者周围神经毒性、恶心呕吐以及手足综合征Ⅲ~Ⅳ级发生率、白细胞及血小板计数下降、腹泻、肝功能损伤、口腔黏膜炎、贫血、蛋白尿、骨髓抑制Ⅰ~Ⅳ级发生率发生率差异无统计学意义(P>0.05)。结论卡培他滨与雷替曲塞分别联合贝伐珠单抗对晚期结直肠癌患者疾病进展控制效果相似,但雷替曲塞联合贝伐珠单抗疗法在治疗安全性方面优于卡培他滨联合方案。Objective To investigate the clinical effect of capecitabine and raltitrexed combined with bevacizumab in the treatment of advanced colorectal cancer.Methods A total of 100 patients with advanced colorectal cancer admitted to the cancer center of Wuhan Union Medical College Hospital from January 2020 to December 2021 were randomly selected as the study objects,and different groups were divided by lottery.50 patients with blue cards in the carton were selected as the control group,and 50 patients with red cards were selected as the observation group.Control group was treated with capecitabine combined with bevacizumab,and observation group was treated with raltitrexed combined with bevacizumab.Both groups were treated for 6 weeks and followed up for 4 months.Objective response rate(ORR),disease control rate(DCR),progression-free survival,(PFS),overall survival(OS)and the incidence of adverse reactions were compared and analyzed.Results After treatment,there were no significant differences in ORR,DCR,PFS and OS between the two groups(P>0.05),and after treatment,the incidence of adverse reactions in different groups of patients were statistically significant(P<0.05),that is,the incidence of gradeⅠ~Ⅱperipheral neurotoxicity,nausea and vomiting and handfoot syndrome in the observation group were lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of nausea and vomiting,gradeⅢ~Ⅳincidence of hand-foot syndrome,decreased white blood cell and platelet count,diarrhea,liver function damage,oral mucositis,anemia,proteinuria,and myelosuppression gradeⅠ~Ⅳ(P>0.05).Conclusion Capecitabine and raltitrexed combined with bevacizumab have similar effects on disease progression control in patients with advanced colorectal cancer,but the combination of ralpatitrexed and bevacizumab is superior to capecitabine combination regimen in terms of treatment safety.

关 键 词：卡培他滨 雷替曲塞 贝伐珠单抗 结直肠癌 不良反应 生存期 

分 类 号：R635[医药卫生—外科学]