雷替曲塞与5-氟尿嘧啶联合奥沙利铂治疗晚期结直肠癌的疗效比较

目的比较雷替曲塞与5-氟尿嘧啶（5-Fu）/亚叶酸钙（LV）联合奥沙利铂治疗晚期结直肠癌的疗效、不良反应和生存期。方法经病理组织学确诊的晚期结直肠癌患者45例,23例（A组）采用雷替曲塞联合奥沙利铂方案化疗,22例（B组）采用5-Fu/LV联合奥沙利铂方案化疗,观察疗效、疾病控制率及不良反应,并随访及观察无疾病进展时间、总生存时间及1年生存率。结果 A、B两组患者,近期有效率分别为42.86%和15.00%（P〈0.05）;疾病控制率分别为80.95%和65.00%（P〉0.05）;A组转氨酶升高发生率高于B组,B组呕吐发生率高于A组,但均无明显差异（均P〉0.05）;中位疾病进展时间分别为8.9个月和5.6个月（P〈0.05）;中位生存期分别为12.9个月和10.7个月,1年生存率分别为52.4%和40%（均P〉0.05）。结论雷替曲塞联合奥沙利铂方案是晚期复发转移性结直肠癌有效的姑息治疗方案,疗效优于传统的5-Fu/LV联合奥沙利铂方案。

Comparison of Raltitrexed Plus Oxaliplatin and 5-Fluorouracil/Leucovorin Plus Oxaliplatin in Treatment of Advanced Colorectal Carcinoma

Objective To evaluate the efficacy,side effects,survival of combined chemotherapy of raltitrexed and 5-fluorouracil（5-Fu）/leucovorin（LV） plus oxaliplatin for advanced colorectal cancer.Methods Forty-five cases of advanced colorectal cancer confirmed by pathology were included in this study.The patients in group A（n=23） received raltitrexed plus oxaliplatin,and those in group B（n=22） were treated with 5-Fu/LV plus oxaliplatin.Both regimens had 21-day cycle,i.e.,the treatment was repeated once every 3 wk and the side effects were evaluated.The efficacy was estimated two cycles after chemotherapy.Results The effective rates was 42.86% and 15.00% in group A and B,respectively,and there was significant difference between them（P0.05）.And the disease control rate was 89.95% and 65.00 in group A and B without significant difference（P0.05）.The elevated transaminase enzymes in group A was higher than that in group B（43.48% vs 36.36%,P0.05）,and the vomiting in group B was higher than that in group A（59.09% vs 39.13%,P0.05）.The 1-year survival rate（52.4% vs 40.0%,P0.05）,median progression-free survival time（8.9 months vs 5.6 months,P0.05）,and median overall survival time（12.9 months vs 10.7 months,P0.05） were not markedly different between group A and B.Conclusion Although the efficacy rate of raltitrexed plus oxaliplatinl is better than 5-Fu/LV plus oxaliplatinl,there is no difference in median overall survival time between them.