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目的比较草酸铂及羟基喜树碱联合亚叶酸钙和氟尿嘧啶(5-FU)辅助化疗方案治疗进展期结直肠癌的疗效和不良反应。方法选择某院自2009年12月～2010年5月经病理证实的进展期结直肠癌患者98例,其中49例(OH组)采用草酸铂130mg/m2联合羟基喜树碱6.0mg/m2,5-FU1000(mg/m2.d)持续静脉泵入1～2d,亚叶酸钙200mg/(m2.d),连续化疗92个周期;49例(HLF组)采用羟基喜树碱6mg/m2+生理盐水250ml,5-FU1000(mg/m2.d)持续静脉泵入1～2d,亚叶酸钙200mg/(m2.d),连续化疗43个周期,2～3周期后对两组的疗效进行评价,同时观察两组的不良反应。结果 OH组、HLF组患者的近期有效率分别为34.69%(17/49)、28.57%(14/49),两组比较疗效差异无统计学意义(P﹥0.05);两组KPS改善情况比较差异无统计学意义(P﹥0.05)。不良反应主要为感觉神经末梢毒性、骨髓抑制、呕吐、腹泻等,两组间Ⅲ、Ⅳ度不良反应以血液学毒性和胃肠道反应为主,其中腹泻发生率HLF组高于OH组,比较差异有统计学意义(P﹤0.05)。结论草酸铂及羟基喜树碱联合亚叶酸钙和氟尿嘧啶治疗进展期结直肠癌,两组的疗效相似,草酸铂外周神经末梢毒性较为常见,羟基喜树碱的腹泻不良反应较为常见。
Objective To compare the efficacy and side effects of oxaliplatin and hydroxycamptothecin in combination with leucovorin and 5-fluorouracil adjuvant chemotherapy in the treatment of advanced colorectal cancer. Methods A total of 98 patients with advanced colorectal cancer confirmed by pathology from December 2009 to May 2010 in our hospital were selected. Forty-nine patients (OH group) were treated with oxaliplatin 130 mg / m2 and hydroxycamptothecin 6.0 mg / m2,5 Continuous infusion of 1 ~ 2d, leucovorin 200mg / (m2.d), 92 cycles of continuous chemotherapy; 49 cases (HLF group) with hydroxy camptothecin 6mg / m2 + saline 250ml, 5-FU1000 (mg / m2.d) continuous intravenous infusion of 1 ~ 2d, leucovorin 200mg / (m2.d), continuous chemotherapy for 43 cycles, 2 to 3 cycles after the efficacy of the two groups were evaluated, Adverse reactions were observed in both groups. Results The effective rates of OH group and HLF group were 34.69% (17/49) and 28.57% (14/49) respectively, there was no significant difference between the two groups (P> 0.05). The improvement of KPS in both groups were compared The difference was not statistically significant (P> 0.05). Adverse reactions were mainly sensory nerve endings, myelosuppression, vomiting and diarrhea. The adverse reactions of grade Ⅲ and Ⅳ in both groups were mainly hematological toxicity and gastrointestinal reactions. The incidence of diarrhea was higher in HLF group than in OH group The difference was statistically significant (P <0.05). Conclusion oxaliplatin and hydroxycamptothecin combined with folinic acid and fluorouracil for the treatment of advanced colorectal cancer, the two groups of similar efficacy, toxicity of peripheral nerve endings of oxaliplatin are more common, adverse reactions of hydroxycamptothecin diarrhea is more common.