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目的:比较羟基喜树碱联合草酸铂(OH方案)和羟基喜树碱联合亚叶酸钙、氟尿嘧啶(HLF方案)治疗进展期结直肠癌的临床疗效和安全性。方法:经病理证实的进展期结直肠癌病例59例,37例采用OH方案化疗,22例采用HLF方案化疗,观察化疗毒副反应,2周期后评价疗效,随访观察无疾病进展生存期、总生存期,统计1年生存率。结果:OH和HLF方案化疗完全缓解率均为0,部分缓解率分别为32.4%(12/37)和22.7%(5/22),两组差异无统计学意义(P>0.05);中位无进展生存期(mPFS)分别为5.7个月和7.3个月,两组差异无统计学意义(P>0.05);中位总生存期(mOS)分别为11.1个月和10.1个月,两组差异无统计学意义(P>0.05);1年生存率分别为30.98%和15.02%,两组差异无统计学意义(P>0.05)。两组Ⅲ、Ⅳ度毒副反应均以骨髓抑制和消化道反应为主,其中粒细胞减少、恶心和呕吐、腹泻、外周神经毒性的发生率方面,OH组均高于HLF组(P<0.05)。结论:OH和HLF方案治疗进展期结直肠癌疗效相似,前者粒细胞减少、胃肠道反应和外周神经毒性较常见,而贫血和血小板减少两者相似。
OBJECTIVE: To compare the clinical efficacy and safety of hydroxycamptothecin combined with oxaliplatin (OH) and hydroxycamptothecine in combination with leucovorin and fluorouracil (HLF) regimens for advanced colorectal cancer. Methods: Fifty-nine patients with advanced colorectal cancer were confirmed pathologically, 37 patients were treated with OH regimen, 22 patients were treated with HLF regimen. The side effects of chemotherapy were observed, and the efficacy was evaluated after 2 cycles. Follow-up observation of progression-free survival, total survival Lifetime, statistical 1-year survival rate. Results: The complete remission rate of OH and HLF chemotherapy was 0, and the partial remission rate was 32.4% (12/37) and 22.7% (5/22) respectively. There was no significant difference between the two groups (P>0.05); The progression-free survival (mPFS) was 5.7 months and 7.3 months, respectively. There was no significant difference between the two groups (P>0.05); the median overall survival (mOS) was 11.1 months and 10.1 months, respectively. The difference was not statistically significant (P>0.05); the one-year survival rates were 30.98% and 15.02%, respectively, and there was no significant difference between the two groups (P>0.05). Both the III and IV toxicities of the two groups were mainly myelosuppression and gastrointestinal reactions. The incidence of neutropenia, nausea and vomiting, diarrhea, and peripheral nerve toxicity were higher in the OH group than in the HLF group (P<0.05). ). CONCLUSIONS: The efficacy of OH and HLF regimens in the treatment of advanced colorectal cancer is similar, with neutropenia, gastrointestinal reactions and peripheral neurotoxicity being more common, and anemia and thrombocytopenia both being similar.