雷替曲塞联合肝动脉化疗栓塞术在晚期大肠癌肝转移中的应用

目的评估雷替曲塞联合肝动脉化疗栓塞(TACE)术在晚期大肠癌肝转移中的疗效及安全性。方法选取晚期大肠癌术后肝转移患者73例,随机分为观察组(n=37)和对照组(n=36)。观察组予以雷替曲塞3 mg·m-2介入下肝动脉灌注化疗联合栓塞治疗,对照组静脉输注同等剂量雷替曲塞进行化疗;2组均每4周治疗1次。比较2组近、远期疗效,观察治疗期间不良反应及治疗2个月后丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素、癌胚抗原(CEA)和糖类抗原(CA)19-9水平下降情况。结果观察组疾病控制率和客观缓解率分别为70%和46%,显著高于对照组的47%和22%(P <0.05)。观察组中位疾病进展时间及1、2年生存率分别为17.4个月、81%和54%,对照组分别为10.2个月、58%和31%,2组比较差异均有显著意义(P <0.05)。2组不良反应以Ⅰ~Ⅱ级为主,恶心、腹泻、口腔黏膜炎等不良反应均无显著差异(P> 0.05)。治疗2个月后,观察组ALT、AST、总胆红素、CEA及CA19-9水平下降情况均优于对照组(P <0.05)。结论雷替曲塞联合TACE可有效控制晚期大肠癌肝转移的肿瘤进展,提高患者生存率,且安全性高。

Application of raltitrexed combined with transarterial chemoembolization in advanced colorectal cancer with liver metastasis

AIM To evaluate the efficacy and safety of raltitrexed combined with transarterial chemoembolization(TACE) in advanced colorectal cancer with liver metastasis. METHODS Seventy-three patients with advanced liver metastasis after colorectal cancer surgery were collected and randomly divided into observation group(n = 37) and control group(n = 36). The patients in the observation group were treated with hepatic arterial infusion chemotherapy combined with embolization under the intervention of raltitrexed 3 mg·m-2, while those in the control group were intravenously infused raltitrexed at the same dose. Both groups were treated every 4 weeks. The short-term and long-term efficacies were compared between two groups, and the adverse reactions during treatment and the levels of alanine aminotransferase(ALT),aspartate transaminase(AST), total bilirubin, carcino-embryonic antigen(CEA) and carbohydrate antigen(CA)19-9 two months after treatment were observed. RESULTS The disease control rate and objective response rate were 70% and 46% in the observation group, which were significantly higher than those in the control group(47% and 22%, P < 0.05). The median time to progression, one and two year survival rates were 17.4 months, 81% and 54% in the observation group respectively, while 10.2 months, 58% and 31% in the control group, with significant difference(P < 0.05). The adverse reactions of the two groups were mainly grades Ⅰ to Ⅱ, and there were no significant differences in nausea, diarrhea and oral mucositis(P > 0.05). After two months of the treatment, the decreased levels of ALT, AST, total bilirubin, CEA and CA19-9 in the observation group were superior to those in the control group(P < 0.05). CONCLUSION Raltitrexed combined with TACE can effectively control the progression of advanced colorectal cancer with liver metastasis, improve the survival rate, and have high safety.