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目的探讨雷替曲塞联合奥沙利铂与5-氟尿嘧啶和亚叶酸钙联合奥沙利铂方案治疗晚期结直肠癌的疗效及不良反应。方法选择2010年6月至2014年1月间收治的经病理学明确诊断的126例晚期结直肠癌患者,按随机数字表法分为治疗组和对照组,每组各63例。治疗组患者采用雷替曲塞联合奥沙利铂方案治疗,对照组患者采用5-氟尿嘧啶和亚叶酸钙联合奥沙利铂方案治疗。观察两组患者的临床疗效和不良反应等方面的差异。结果治疗组患者完全缓解0例,部分缓解22例,稳定23例,进展18例,总有效率为34.9%(22/63);对照组患者完全缓解0例,部分缓解20例,稳定23例,进展20例,总有效率为31.7%(20/63),两组患者的总有效率比较差异无统计学意义(P>0.05)。两组患者均有骨髓抑制发生,以I、Ⅱ度为主;治疗组患者恶性呕吐、腹泻和黏膜炎的发生率低于对照组,差异有统计学意义(P<0.05);两组患者均未出现严重的肝、肾、心脏毒性,无治疗相关性死亡。结论雷替曲塞联合奥沙利铂方案治疗晚期结直肠癌的疗效与5-氟尿嘧啶和亚叶酸钙联合奥沙利铂方案疗效相当,但不良反应较轻,值得临床广泛应用。
Objective To investigate the efficacy and adverse reactions of raltitrexed combined with oxaliplatin, 5-fluorouracil and leucovorin plus oxaliplatin in the treatment of advanced colorectal cancer. Methods One hundred and sixty-six patients with advanced colorectal cancer diagnosed by pathology from June 2010 to January 2014 were randomly divided into treatment group and control group, with 63 cases in each group. The patients in the treatment group were treated with raltitrexed plus oxaliplatin and the patients in the control group were treated with 5-fluorouracil and leucovorin plus oxaliplatin. The clinical efficacy and adverse reactions of the two groups were observed. Results In the treatment group, there were 0 patients in complete remission, 22 patients in partial remission, 23 in stable and 18 in progression. The total effective rate was 34.9% (22/63). In control group, 0 patients were completely relieved, 20 patients were partially relieved, and 23 patients were stable , 20 cases progressed, the total effective rate was 31.7% (20/63). There was no significant difference in the total effective rate between the two groups (P> 0.05). Myelosuppression occurred in both groups, with I and II degrees as the main factors. The incidences of malignant vomiting, diarrhea and mucositis in the treatment group were significantly lower than those in the control group (P <0.05) No serious liver, kidney, cardiotoxicity, no treatment-related death. Conclusion The efficacy of raltitrexed and oxaliplatin in the treatment of advanced colorectal cancer is comparable to that of 5-fluorouracil and leucovorin combined with oxaliplatin, but the adverse reactions are mild and worthy of clinical application.