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目的总结探讨伊立替康与卡培他滨联合作为晚期结直肠癌患者二线治疗方案的应用情况。方法选择2012-03-2014-12我院收治的60例病理明确诊断为晚期结直肠癌、经FOLFOX 4化疗方案失败的患者为研究对象,随机分为观察组和对照组各30例,对照组患者单纯应用卡培他滨化疗,观察组联合应用伊立替康与卡培他滨化疗,1个化疗周期为21天,两组患者均接受2个化疗周期治疗,评价两组患者临床受益、临床疗效、不良反应及随访情况。结果观察组患者临床受益率80.00%明显高于对照组50.00%,差异具有统计学意义(P<0.05);观察组CR2例、PR3例,对照组CR1例、PR1例,观察组近期治疗有效率16.67%明显高于对照组6.67%,但差异不具有统计学意义(P>0.05)。观察组平均生存时间(12.3±1.2)月明显高于对照组(8.1±1.5)月,差异具有统计学意义,P<0.05。两组不良反应都主要表现为Ⅰ~Ⅱ度恶心呕吐和粒细胞计数下降、Ⅱ~Ⅲ度急性胆碱能综合征和腹泻等,组间不良反应率无统计学差异(P>0.05)。结论对于FOLFOX方案化疗失败的晚期结直肠癌患者来说选择伊立替康联合卡培他滨作为二线治疗方案是可取的,且临床受益率及疗效较高,毒副反应也在可耐受范围内。
Objective To summarize the application of irinotecan combined with capecitabine in the second-line treatment of patients with advanced colorectal cancer. Methods Sixty patients with pathologically confirmed advanced colorectal cancer who were admitted to our hospital from March 2012 to December 2014 were enrolled in this study. Patients who failed the FOLFOX 4 chemotherapy regimen were randomly divided into observation group (30 cases) and control group (30 cases), control group The patients were treated with capecitabine alone. The patients in the observation group were treated with irinotecan and capecitabine. The duration of one chemotherapy cycle was 21 days. Both groups received two chemotherapy cycles to evaluate the clinical benefit, clinical benefit Efficacy, adverse reactions and follow-up. Results The clinical benefit rate in the observation group was significantly higher than that in the control group (80.00%, 50.00%, P <0.05). The CR2, PR3, CR1, PR1, 16.67% was significantly higher than the control group 6.67%, but the difference was not statistically significant (P> 0.05). The mean survival time of the observation group (12.3 ± 1.2) months was significantly higher than that of the control group (8.1 ± 1.5) months, the difference was statistically significant, P <0.05. The two groups of adverse reactions are mainly manifested as Ⅰ ~ Ⅱ degree of nausea and vomiting and decreased granulocyte count, Ⅱ ~ Ⅲ degree acute cholinergic syndrome and diarrhea, the adverse reaction rate was no significant difference (P> 0.05). Conclusion It is advisable to use irinotecan combined with capecitabine for second-line treatment in patients with advanced colorectal cancer who failed chemotherapy with FOLFOX regimen, and the clinical benefit rate and curative effect are high, and the side effects are also tolerable .