奥沙利铂为基础的方案治疗老年晚期结直肠癌的临床观察

目的探讨奥沙利铂为基础的方案治疗老年晚期结直肠癌的疗效及安全性。方法选择经病理学确诊的46例老年晚期结直肠癌患者,均采用奥沙利铂为基础的方案化疗,其中包括FOLFOX方案18例,XELOX方案25例,另有3例为奥沙利铂联合氟尿嘧啶方案。所有患者至少完成2个周期的化疗,观察客观有效率(RR)、疾病控制率(DCR)、中位疾病进展时间(TTP)、总生存时间(OS)和化疗相关不良反应。结果 46例患者中,RR及DCR分别为39.1%和80.4%,TTP和OS分别为7.0月和24.0月。化疗相关不良反应可以耐受,Ⅰ~Ⅱ度不良反应主要包括中性粒细胞减少、血小板减少、贫血等,Ⅲ~Ⅳ度不良反应少见,主要为中性粒细胞减少和腹泻。结论奥沙利铂为基础的方案治疗老年晚期结直肠癌安全有效,值得在老年人群中进一步研究推广。

Efficacy and safety of regimens on the basis of oxaliplatin in elderly patients with advanced colorectal cancer

Objective To observe the efficacy and safety of regimens on the basis of oxaliplatin in the treatment of elderly patients with advanced colorectal cancer.Methods Forty-six advanced colorectal cancer patients who aged from 65 to 83 years received chemotherapy of oxaliplatin and fluoropyrimidine. 18 of them received FOLFOX and 25 received XELOX,and 3 patients used other regimen which contain oxaliplatin and fluoropyrimidine.All patients completed 2 cycles at least.The response rate(RR),disease control rate(DCR),time to progression(TTP),overall survival(OS),and chemotherapy associated toxicity were evaluated.Results The overall response rate was 39.1%,disease control rate was 80.4%,including 18 partial response(PR),19 stable disease (SD) and 9 progression(PD).The median time to progression(TTP) and median overall survival(OS) was 7.0 months and 24.0 months respectively.Chemotherapy related adverse reaction could tolerate.I～II degree adverse reactions including neutropenia induce,thrombocytopenia,anemia et al.The main III or IV grade hematological and non-hematological toxicities were neutropenia and diarrhea.Conclusion The chemotherapy of oxaliplatin and fluoropyrimidine is effective and safe in elderly patients with advanced CRC,and it is worthy of further study.