结肠癌术后两周及三周方案辅助化疗疗效的临床观察(1)
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【摘要】目的 观察并分析96例结肠癌患者根治术后使用两周及三周方案辅助化疗疗效，预后及毒副反应的比较。方法 采集并分析2005年1月至2007年7月南华大学附一医院收治的96例行结肠癌根治术后的患者，其中Ⅲ期患者70例，Ⅱ期患者26例(Ⅱ期患者均为有高危因素的患者)。根据年龄，病理分期，KPS(卡氏评分)评分等分为二组，一组采用欧美常用的FOLFOX4(奥沙利铂 85mg/m2 ivgtt d1 亚叶酸钙 200mg/m2 ivgtt d1,25-氟尿嘧啶 400mg/m2 iv d1,25-氟尿嘧啶 600mg/m2 civ22h d1,2 每2周重复)方案，一组采用我国地市级医院常用的L-OHP+CF+5-Fu(奥沙利铂 130mg/m2 ivgtt d1亚叶酸钙 200mg/m2 ivgtt d1-55-氟尿嘧啶 350mg/m2·dciv 120h 每3周重复)方案，其中FOLFOX4方案行12周期，L-OHP+CF+5-Fu方案行8周期。主要观察指标为3年DFS(无复发生存)，次要指标为药物的毒性反应。结果 两周方案组3年DFS为56.3%，三周方案组3年DFS为52.1%，3年DFS无统计学差异(P=0.021)。两周方案的不良反应主要为恶心呕吐及骨髓抑制，三周方案的口腔黏膜炎更明显。患者对三周方案的依从性及耐受性更高。结论 我们认为二种化疗方案均可用于结肠癌根治术后(有高危因素的Ⅱ期及Ⅲ期的患者)辅助化疗，作为我国常用的三周方案使用更方便，患者的依从性及耐受性更好，更符合我国国情，值得进一步推广与研究。
【关键词】辅助化疗；DFS(无复发生存) L-OHP(奥沙利铂) CF(亚叶酸钙) 5-Fu(5-氟尿嘧啶) civ(持续静脉输注)
中图分类号：R735.35 文献标识码：A 文章编号：1005-0515(2011)4-023-03
【Abstract】Objective Observed and analyzed the effect, and drug toxicity of using two weeks and three weeks adjuvant chemotherapy after Radical surgery on 96 patients with colon cancer, and compared the prognosis between two chemotherapy regimens. Method Collected and analyzed 96 colon cancer patients after Radical surgery accepted by the first affiliated hospital of nanhua university in January 2005-July 2007. In which 70 patients with stage Ⅲ, 26 patients with stage Ⅱ(those patients with risk factors). According to age, pathological stage, KPS score, etc. Divided into two groups, one commonly used in Europe and America FOLFOX4 program (oxaliplatin 85mg/m2 ivgtt d1 leucovorin 200mg/m2 ivgtt d1, 2 5-fluorouracil 400mg/m2 iv d1, 2 5 - fluorouracil 600mg/m2 civ22h d1, 2 Repeat every 2 weeks), another commonly used in levelcity hospital of our contry L-OHP + CF +5- Fu program (oxaliplatin 130mg/m2 ivgtt d1 leucovorin 200mg/m2 ivgtt d1-5 5 - fluorouracil 350mg/m2·d civ120h Repeat every 3 weeks)，Which FOLFOX4 program for 12 cycles, L-OHP+CF+5- Fu program for 8 cycles. The main outcome measures is 3-year DFS(Disease-free survival), Secondary indicators are drug toxicity. Result in the two weeks of the program group 3-year DFS is 56.3%。in the three-week program of group 3-year DFS is 52.1%。3-year DFS has not statistically significant differences(P=0.021). The main drug toxicity of the two weeks of the program is nausea ,vomit and myelosuppression ......
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