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中国癌症防治杂志

中国癌症防治杂志 ›› 2018, Vol. 10 ›› Issue (6): 460-464.doi: 10.3969/j.issn.1674-5671.2018.06.08

• 临床应用 • 上一篇    下一篇

伊立替康联合雷替曲塞或5-FU二线治疗晚期结直肠癌的疗效比较

  

  1. 安阳市肿瘤医院 内科，胸外科
  • 出版日期:2018-12-25 发布日期:2019-01-29
  • 通讯作者: 梁文昌 E-mail：zxiushui1234@163.com
  • 基金资助:

    “十三五重大新药创制专项”资助项目（18PJ294）

Comparison of efficacy of irinotecan  combined with raltitrexed or 5-FU  as second-line treatment for advanced colorectal cancer

  • Online:2018-12-25 Published:2019-01-29

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摘要：

目的 比较伊立替康联合雷替曲塞方案与伊立替康联合5-FU方案二线治疗晚期结直肠癌的临床疗效。方法 选取经一线化疗失败行二线治疗的60例晚期结直肠癌患者，根据不同二线治疗方案，将其分为观察组和对照组，每组30例。观察组采用伊立替康联合雷替曲塞方案治疗，对照组采用伊立替康联合5-FU方案（FOLFIRI方案），治疗结束后比较两组患者的近期疗效及不良反应，并观察总生存期（OS）和疾病进展时间（TTP）。结果 观察组和对照组患者的总有效率比较差异无统计学意义（26.67% vs 13.33%，χ2=1.67，P=0.20）；观察组患者疾病控制率高于对照组，差异有统计学意义（63.33% vs 36.67%，χ2=4.27，P=0.04）；观察组中位OS和中位TTP较对照组长，两组比较差异均有统计学意义（9.9个月 vs 7.5个月，χ2=4.461，P=0.012；5.0个月 vs  3.7个月，χ2=6.735，P=0.022）；观察组骨髓抑制、胃肠道不良反应等发生率与对照组比较差异无统计学意义（P＞0.05）。结论 伊立替康联合雷替曲塞二线治疗晚期结直肠癌疗效肯定，较FOLFIRI方案可延长生存期，不良反应更轻，可作为一线化疗失败患者的可选治疗方案。

关键词: 结直肠癌, 伊立替康, 雷替曲塞, FOLFIRI方案, 临床疗效, 生存

Abstract:

Objective  To compare the clinical efficacy of irinotecan plus raltitrexed and irinotecan plus 5-FU（FOLFIRI） in the second-line treatment of patients with advanced colorectal cancer. Methods A total of 60 patients with advanced colorectal cancer were enrolled after first-line chemotherapy failure. They were divided into observation group（irinotecan plus raltitrexed） and control group （FOLFIRI），30 patients in each group. The clinical efficacy and adverse reaction，over survival （OS） and time to progresion （TTP） were observed. Results There was no significant difference in the response rate between the observation group and the control group（26.67% vs 13.33%，χ2=1.67，P=0.20）. The disease control rate in the observation group was higher than that in the control group，and the difference was statistically significant （ 63.33% vs 36.67%，χ2=4.27，P=0.04）. The median OS and median TTP in the observation group were longer than those in the control group （9.9 months vs 7.5 months， χ2=4.461，P=0.012；5.5 months vs 3.7 months， χ2=6.735，P=0.022）. The gastrointestinal advese reactions between the two groups were not significantly different （P>0.05）. Conclusions Irinotecan combined with raltitrexed as the second line treatment showed satisfactory efficacy and safety to treat the  patients with advanced colorectal cancer. It can prolong survival and reduce adverse reactions compared with FOLFIRI，and it is worthy of clinical application.