卡培他滨维持治疗老年晚期转移性结直肠癌的生存分析

目的 评价卡培他滨维持治疗老年晚期转移性结直肠癌的疗效及安全性。方法 自2007年8月1日—2011年8月1日在辽宁医学院附属第一医院完成一线化疗后达到疾病控制（CR+PR+SD）的老年晚期转移性结直肠癌患者接受两种不同的治疗策略（按患者自己意愿）。治疗组30例，予卡培他滨维持治疗（卡培他滨常规量为1 000 mg/m2,每日2次，连用2周，休息1周，每21天为1周期）；对照组48例，观察直至疾病进展再接受进一步治疗。观察两组患者的疾病进展时间（TTP）、总生存期（OS）及不良反应。结果 维持治疗组和对照组的中位疾病进展时间分别为10.3月、6.5月，差异有统计学意义（P=0.000231）；中位总生存期分别为31.4月、18.4月，差异有统计学意义（P=0.000319）。维持治疗组的主要不良反应为手足综合征、消化道反应、较轻的血液学毒性及肝肾功能损害。结论 卡培他滨维持治疗通过延长老年晚期转移性结直肠癌患者的疾病进展时间和总生存期可使其获益且耐受性良好，值得扩大样本进一步研究。

Survival Analysis of Capecitabine Maintenance Therapy in Elderly Patients with#br# Advanced Metastatic Colorectal Cancer

Objective To evaluate the effi cacy and toxicity of capecitabine maintenance therapy in elderlypatients with advanced metastatic colorectal cancer. Methods From August 1st, 2007 to August 1st,2011,after they had achieved clinical response (CR+PR+SD) from fi rst-1ine chemotherapy, elderly patients withadvanced metastatic colorectal cancer in the fi rst affi liated hospital of liaoning medical university received twodifferent treatment strategies, according to the patient’s own intention. The treatment group (30 cases ) weretreated with capecitabine maintenance therapy of capecitabine 1 000 mg/m2 po bid dl-14,q21d.The controlgroup (48 cases) did not receive any further chemotherapy until disease progression.TTP and overall survivaltime of two groups, and the toxicity of the maintenance group were observed. Results The median time toprogression was 10.3 months vs. 6.5 months (P = 0.000231), the median overall survival were 31.4 monthsvs. 18.4 months (P = 0.000319), of patients in maintenance therapy group and control group, respectively. Thedifferences between them were statistically signifi cant. The major side effects in maintenance therapy groupwere hand-foot syndrome, digestive tract reaction, hematology toxicity, mild impairment of liver and kidney’ sfunction. Conclusion Capecitabine maintenance therapy could benefi t the elderly patients with advancedmetastatic colorectal cancer by extending time to progression and overall survival, and is generally welltolerated, worthy of enlarging the sample for further research.