奥沙利铂联合替吉奥治疗晚期结直肠癌的临床效果
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摘要
目的探讨奥沙利铂联合替吉奥治疗晚期结直肠癌患者的临床效果。方法回顾性分析2013年3月~2015年1月辽宁省肿瘤医院收治的晚期结直肠癌患者86例的临床资料,根据化疗方案的不同将其分为观察组(46例)和对照组(40例)。观察组采用奥沙利铂联合替吉奥治疗,对照组采用奥沙利铂联合卡培他滨治疗,21 d为1个周期。两组患者均治疗6个周期。比较两组患者临床有效率、疾病控制率、远期预后、不良反应发生率,以及治疗前后肿瘤标志物水平。结果观察组临床有效率(58.70%)和疾病控制率(71.74%)均高于对照组(35.00%、50.00%),差异有统计学意义(P<0.05);Log-rank检验显示,观察组死亡风险率显著低于对照组(χ2=3.952,P<0.05);观察组(3级以上)总不良反应发生率(10.87%)显著低于对照组(27.50%),差异有统计学意义(P<0.05);治疗后,两组患者癌胚抗原(CEA)、甲胎蛋白(AFP)、癌抗原19-9(CA19-9)和胸苷激酶1(TK1)等肿瘤标志物水平显著低于治疗前,且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论 奥沙利铂联合替吉奥方案治疗晚期结直肠癌的效果和安全性较好,且能够有效降低肿瘤标志物水平,改善患者的生存预期。
Objective To investigate the effects of Oxaliplatin combined with Tegafur, Gimeracil and Oteracil Potassium in the treatment of patients with advanced colorectal cancer. Methods The clinical data of 86 patients with advanced colorectal cancer admitted to Liaoning Cancer Hospital & Institute from March 2013 to January 2015 was analyzed retrospectively, and they were divided into observation group(46 cases) and control group(40 cases) according to the difference of chemotherapy regimen. The observation group was given Oxaliplatin combined with Tegafur, Gimeracil and Oteracil Potassium. The control group was given Oxaliplatin combined with Capecitabine, 21 d was as a course, both groups were treated for 6 courses. The clinical effective rate, disease control rate, long-term prognosis, the incidence of adverse reactions and the levels of tumor markers before and after treatment between the two groups were compared.Results The clinical effective rate(58.70%) and disease control rate(71.74%) in the observation group were significantly higher than those in the control group(35.00%, 50.00%)(P < 0.05); Log-rank test showed that the risk of death in the observation group was significantly lower than that in the control group(χ2= 3.952, P < 0.05). The total incidence of adverse reactions(above 3 levels) in the observation group(10.87%) was significantly lower than that of the control group(27.50%)(P < 0.05). After treatment, the levels of tumor markers such as carcino-embryonic antigen(CEA), alpha fetoprotein(AFP), cancer antigen 19-9(CA19-9) and thymidine kinase 1(TK-1) in the two groups were significantly lower than those before treatment, which of the observation group were significantly lower than those of the control group, the differences were statistically significant(P < 0.05). Conclusion The efficacy and safety of Oxaliplatin combined with Tegafur, Gimeracil and Oteracil Potassium in the treatment of advanced colorectal cancer are good,which can effectively decrease the levels of tumor markers and improve the prognosis of patients.
Objective To investigate the effects of Oxaliplatin combined with Tegafur, Gimeracil and Oteracil Potassium in the treatment of patients with advanced colorectal cancer. Methods The clinical data of 86 patients with advanced colorectal cancer admitted to Liaoning Cancer Hospital & Institute from March 2013 to January 2015 was analyzed retrospectively, and they were divided into observation group(46 cases) and control group(40 cases) according to the difference of chemotherapy regimen. The observation group was given Oxaliplatin combined with Tegafur, Gimeracil and Oteracil Potassium. The control group was given Oxaliplatin combined with Capecitabine, 21 d was as a course, both groups were treated for 6 courses. The clinical effective rate, disease control rate, long-term prognosis, the incidence of adverse reactions and the levels of tumor markers before and after treatment between the two groups were compared.Results The clinical effective rate(58.70%) and disease control rate(71.74%) in the observation group were significantly higher than those in the control group(35.00%, 50.00%)(P < 0.05); Log-rank test showed that the risk of death in the observation group was significantly lower than that in the control group(χ2= 3.952, P < 0.05). The total incidence of adverse reactions(above 3 levels) in the observation group(10.87%) was significantly lower than that of the control group(27.50%)(P < 0.05). After treatment, the levels of tumor markers such as carcino-embryonic antigen(CEA), alpha fetoprotein(AFP), cancer antigen 19-9(CA19-9) and thymidine kinase 1(TK-1) in the two groups were significantly lower than those before treatment, which of the observation group were significantly lower than those of the control group, the differences were statistically significant(P < 0.05). Conclusion The efficacy and safety of Oxaliplatin combined with Tegafur, Gimeracil and Oteracil Potassium in the treatment of advanced colorectal cancer are good,which can effectively decrease the levels of tumor markers and improve the prognosis of patients.
引文
[1]李道娟,李倩,贺宇彤.结直肠癌流行病学趋势[J].肿瘤防治研究,2015,42(3):305-310.
[2]孙勇,何磊,程元光,等.高龄结直肠癌患者根治性手术的危险因素分析[J].安徽医学,2014,35(10):1388-1391.
[3]刘福银,孟丽娟,王峻,等.替吉奥联合奥沙利铂与卡培他滨联合奥沙利铂一线治疗老年晚期胃癌的疗效分析[J].河北医药,2014,58(19):55-56.
[4]Cai X,Cao W,Ding H,et al.Analysis of UGT1A1*28 genotype and SN-38 pharmacokinetics for irinotecan-based chemotherapy in patients with advanced colorectal cancer:results from a multicenter,retrospective study in Shanghai[J].J Cancer Res Clin Oncol,2013,139(9):1579-1589.
[5]Nekatsuka M,Saito H,Sakamoto K,et al.Efficacy of combination chemotherapy using oral fluoropyrimidine S-1with oxaliplatin(SOX)against colorectal cancer in vivo[J].Anticancr Res,2013,32(7):2807.
[6]Jemal A,Siegel R,Ward E,et al.Cancer statistics,2009[J].CA Cancer J Clin,2009,59(4):225-249.
[7]于瑞莲,陈琳.替吉奥联合奥沙利铂治疗晚期结直肠癌的临床观察[J].华西医学,2014,39(2):300-302.
[8]Nekatsuka M,Saito H,Sakamoto K,et al.Efficacy of combination chemotherapy using oral fluoropyrimidine S-1with oxaliplatin(SOX)against colorectal cancer in vivo[J].Anticancr Res,2013,32(7):2807.
[9]李鹏,李成浩.奥沙利铂联合替吉奥治疗晚期结直肠癌的临床疗效观察[J].中国实用医药杂志,2017,12(7):143-144.
[10]Del Vecchio Blanco G,Cretella M,Paoluzi OA,et al.Adenoma,advanced adenoma and colorectal cancer prevalence in asymptomatic 40-to 49-year-old subjects with a first-degree family history of colorectal cancer[J].Colorectal Dis,2013,15(9):1093-1099.
[11]孙翠玲,徐晓宇,高莹莹,等.奥沙利铂联合替吉奥治疗晚期结肠癌患者的临床疗效与安全性[J].中国临床药理学杂志,2017,33(16):1540-1542.
[12]吕芳.替吉奥联合奥沙利铂与卡陪他滨联合奥沙利铂治疗晚期结肠癌的疗效与安全性比较[J].医学信息,2014,11(27):154.
[13]段春霞,傅颖,陈丽霞.替吉奥联合奥沙利铂治疗晚期结直肠癌的近期疗效和不良反应[J].中国肿瘤临床与康复,2016,23(11):1325-1327.
[14]陈倩雅,卢秀仪.观察奥沙利铂联合卡培他滨治疗晚期结肠癌的临床疗效及安全性[J].中国实用医药,2017,12(9):95-97.
[15]Winther SB,魻sterlund P,Berglund A,et al.Randomized study comparing full dose monotherapy(S-1 followed by irinotecan)and reduced dose combination therapy(S-1/oxaliplatin followed by S-1/irinotecan)as initial therapy for older patients with metastatic colorectal cancer:NORDIC 9[J].BMC Cancer,2017,17(1):548.
[16]张凯,刘培培,张伟杰,等.替吉奥胶囊联合奥沙利铂方案加贝伐单抗治疗晚期结直肠癌的临床观察[J].肿瘤防治研究,2014,41(9):1036-1039.
[17]Berretta M,Di Francia R.Comment on“Tegafur gimeracil oter com-bined with oxaliplatin for advanced colorectal cancer.”Is it cost ef-fectiveness?[J].Eur Rev Med Pharmacol Sci,2016,20(1):5-6.
[18]李凌云,解华,张宁,等.奥沙利铂分别联合卡培他滨和替吉奥治疗晚期结直肠癌的临床疗效分析[J].安徽医药,2016,20(8):1570-1572.
[19]Hong YS,Park YS,Lim HY,et al.S-1 plus oxaliplatin versus capecitabine plus oxaliplatin for first-line treatment of patients with metastatic colorectal cancer:A random-mised,noninferiority phase 3 trial[J].Lancet Oncol,2013,13(11):165-176.
[20]张海林,贾爱萍,邢丽.多种肿瘤标志物在结直肠癌患者术后腹腔引流液中水平的表达与疾病的相关性研究[J].国际检验医学杂志,2014,35(1):105-106.
[2]孙勇,何磊,程元光,等.高龄结直肠癌患者根治性手术的危险因素分析[J].安徽医学,2014,35(10):1388-1391.
[3]刘福银,孟丽娟,王峻,等.替吉奥联合奥沙利铂与卡培他滨联合奥沙利铂一线治疗老年晚期胃癌的疗效分析[J].河北医药,2014,58(19):55-56.
[4]Cai X,Cao W,Ding H,et al.Analysis of UGT1A1*28 genotype and SN-38 pharmacokinetics for irinotecan-based chemotherapy in patients with advanced colorectal cancer:results from a multicenter,retrospective study in Shanghai[J].J Cancer Res Clin Oncol,2013,139(9):1579-1589.
[5]Nekatsuka M,Saito H,Sakamoto K,et al.Efficacy of combination chemotherapy using oral fluoropyrimidine S-1with oxaliplatin(SOX)against colorectal cancer in vivo[J].Anticancr Res,2013,32(7):2807.
[6]Jemal A,Siegel R,Ward E,et al.Cancer statistics,2009[J].CA Cancer J Clin,2009,59(4):225-249.
[7]于瑞莲,陈琳.替吉奥联合奥沙利铂治疗晚期结直肠癌的临床观察[J].华西医学,2014,39(2):300-302.
[8]Nekatsuka M,Saito H,Sakamoto K,et al.Efficacy of combination chemotherapy using oral fluoropyrimidine S-1with oxaliplatin(SOX)against colorectal cancer in vivo[J].Anticancr Res,2013,32(7):2807.
[9]李鹏,李成浩.奥沙利铂联合替吉奥治疗晚期结直肠癌的临床疗效观察[J].中国实用医药杂志,2017,12(7):143-144.
[10]Del Vecchio Blanco G,Cretella M,Paoluzi OA,et al.Adenoma,advanced adenoma and colorectal cancer prevalence in asymptomatic 40-to 49-year-old subjects with a first-degree family history of colorectal cancer[J].Colorectal Dis,2013,15(9):1093-1099.
[11]孙翠玲,徐晓宇,高莹莹,等.奥沙利铂联合替吉奥治疗晚期结肠癌患者的临床疗效与安全性[J].中国临床药理学杂志,2017,33(16):1540-1542.
[12]吕芳.替吉奥联合奥沙利铂与卡陪他滨联合奥沙利铂治疗晚期结肠癌的疗效与安全性比较[J].医学信息,2014,11(27):154.
[13]段春霞,傅颖,陈丽霞.替吉奥联合奥沙利铂治疗晚期结直肠癌的近期疗效和不良反应[J].中国肿瘤临床与康复,2016,23(11):1325-1327.
[14]陈倩雅,卢秀仪.观察奥沙利铂联合卡培他滨治疗晚期结肠癌的临床疗效及安全性[J].中国实用医药,2017,12(9):95-97.
[15]Winther SB,魻sterlund P,Berglund A,et al.Randomized study comparing full dose monotherapy(S-1 followed by irinotecan)and reduced dose combination therapy(S-1/oxaliplatin followed by S-1/irinotecan)as initial therapy for older patients with metastatic colorectal cancer:NORDIC 9[J].BMC Cancer,2017,17(1):548.
[16]张凯,刘培培,张伟杰,等.替吉奥胶囊联合奥沙利铂方案加贝伐单抗治疗晚期结直肠癌的临床观察[J].肿瘤防治研究,2014,41(9):1036-1039.
[17]Berretta M,Di Francia R.Comment on“Tegafur gimeracil oter com-bined with oxaliplatin for advanced colorectal cancer.”Is it cost ef-fectiveness?[J].Eur Rev Med Pharmacol Sci,2016,20(1):5-6.
[18]李凌云,解华,张宁,等.奥沙利铂分别联合卡培他滨和替吉奥治疗晚期结直肠癌的临床疗效分析[J].安徽医药,2016,20(8):1570-1572.
[19]Hong YS,Park YS,Lim HY,et al.S-1 plus oxaliplatin versus capecitabine plus oxaliplatin for first-line treatment of patients with metastatic colorectal cancer:A random-mised,noninferiority phase 3 trial[J].Lancet Oncol,2013,13(11):165-176.
[20]张海林,贾爱萍,邢丽.多种肿瘤标志物在结直肠癌患者术后腹腔引流液中水平的表达与疾病的相关性研究[J].国际检验医学杂志,2014,35(1):105-106.