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目的探讨转移性结直肠癌患者采用沙利度胺维持治疗的临床疗效。方法选取2013年2月至2014年12月间大连市第三人民医院收治的42例经化疗联合沙利度胺治疗疾病得到控制的患者,采用随机抛硬币法分为沙利度胺观察组(21例)和对照组(21例)。观察组患者每天口服沙利度胺200 mg至疾病进展,对照组患者完全停药,两组均每1~2个月复查,比较两组患者疾病无进展生存时间、总生存率、生活质量改善和不良反应情况。结果观察组患者无进展生存时间为(3.9±1.3)个月,时间略高于对照组的(3.7±1.2)个月(P>0.05)。观察组和对照组患者1年总生存率分别为66.7%和61.9%,差异无统计学意义(P>0.05)。观察组患者生活质量改善率为71.4%,明显高于对照组(47.6%),差异无统计学意义(P>0.05)。观察组患者出现明显困倦4例、皮疹2例、轻度水肿1例,但症状均可耐受,对治疗无任何影响。结论应用沙利度胺维持治疗转移性结直肠癌未明显延长患者疾病无进展生存及总生存,但可明显降低化疗相关胃肠道反应,提高生活质量。
Objective To investigate the clinical efficacy of thalidomide maintenance therapy in patients with metastatic colorectal cancer. Methods Forty-two patients undergoing chemotherapy and thalidomide treatment were selected from the Third People’s Hospital of Dalian City from February 2013 to December 2014. Patients were randomly divided into the thalidomide group 21 cases) and control group (21 cases). Patients in the observation group were treated with oral thalidomide 200 mg once daily until the disease progressed. Patients in the control group were stopped completely. Both groups were reviewed every 1 to 2 months. The progression-free survival, overall survival and quality of life were compared between the two groups And adverse reactions. Results The progression-free survival time in the observation group was (3.9 ± 1.3) months, slightly higher than that in the control group (3.7 ± 1.2) months (P> 0.05). The 1-year overall survival rates of the observation group and the control group were 66.7% and 61.9%, respectively, with no significant difference (P> 0.05). The improvement rate of quality of life in the observation group was 71.4%, which was significantly higher than that in the control group (47.6%), the difference was not statistically significant (P> 0.05). In observation group, there were 4 patients with obvious drowsiness, 2 cases with rash and 1 case with mild edema, but the symptoms were tolerable and had no effect on the treatment. Conclusion Thalidomide maintenance treatment of metastatic colorectal cancer did not significantly prolong the disease progression-free survival and overall survival, but can significantly reduce chemotherapy-related gastrointestinal reactions and improve quality of life.