2020 年第 4 期 第 15 卷

奥沙利铂不同给药方案联合卡培他滨对结直肠癌肝转移患者的疗效及生存率的影响

Outcomes of patients with colorectal cancer liver metastases treated with different administration modes of oxaliplatin plus capecitabine

作者：马骏1张玉英2陈树军1秦阳1

英文作者：Ma Jun1 Zhang Yuying2 Chen Shujun1 Qin Yang1

单位：1沈阳医学院附属中心医院普外四科110024；2沈阳医学院附属中心医院放射科110024

英文单位：1The 4th Department of General Surgery Central Hospital Affiliated to Shenyang Medical College Shenyang 110024 China; 2Department of Radiological Central Hospital Affiliated　to Shenyang Medical College Shenyang 110024 China

关键词：结直肠癌肝转移；奥沙利铂；卡培他滨；生存率

英文关键词：Colorectalcancerwithlivermetastasis；Oxaliplatin；Capecitabine；Survivalrate

• 摘要：

• 【摘要】目的    探讨奥沙利铂联合卡培他滨不同给药方案对结直肠癌肝转移患者的疗效及生存率的影响。方法    选取沈阳医学院附属中心医院2017年5月至2018年5月收治的结直肠癌肝转移患者110例，完全随机分为对照组和观察组，各55例。对照组接受静脉滴注奥沙利铂并口服卡培他滨治疗，观察组接受肝动脉灌注奥沙利铂并口服卡培他滨治疗，比较2组临床疗效、1年生存率、无进展生存期（PFS）、血清癌胚抗原水平和不良反应发生情况。结果    观察组患者1年生存率和PFS均高于对照组［56.4%(31/55)比36.4%（20/55）、（10.2±2.0）个月比（6.4±1.5）个月］，差异均有统计学意义（均P＜0.05）。2组患者疾病缓解率和疾病控制率比较，差异均无统计学意义（均P＞0.05）。治疗后观察组血清癌胚抗原水平低于对照组［（30±3）μg/L比（46±5）μg/L］，差异有统计学意义（P＜0.001）。2组患者腹泻、呕吐、骨髓抑制、手足综合征发生率比较，差异均无统计学意义（均P＞0.05），观察组周围神经毒性发生率明显低于对照组［12.7%(7/55)比32.7%(18/55)］，差异有统计学意义（P＜0.05）。结论    对结直肠癌肝转移患者采用肝动脉灌注奥沙利铂联合卡培他滨治疗疗效确切，能明显提高患者1年生存率，延长PFS，且不增加不良反应发生率。

• 【Abstract】Objective    To observe the influence of different administration modes of oxaliplatin combined with capecitabine on the curative effect and survival rate in patients suffering from colorectal cancer liver metastases. Methods    A total of 110 colorectal cancer patients with liver metastases admitted to Central Hospital Affiliated to Shenyang Medical College from May 2017 to May 2018 were randomly divided into observation group and control group, with 55 cases in each group. The control group was treated intravenous infusion of oxaliplatin and oral capecitabine. The observation group received oxaliplatin by hepatic arterial infusion and oral capecitabine. Clinical efficacy, 1-year survival rate, progression-free survival(PFS) time, serum carcinoembryonic antigen（CEA） level and adverse reactions were analyzed. Results    The 1-year survival rate and PFS in the observation group were significantly higher/longer than those in the control group［56.4%(31/55) vs 36.4%（20/55）, （10.2±2.0）months vs （6.4±1.5）months］（both P＜0.05）. Disease remission rate and control rate showed no statistical difference between groups(both P＞0.05). After treatment, serum CEA level in the observation group was significantly lower than that in the control group［（30±3）μg/L vs （46±5）μg/L］（P＜0.001）. There were no significant differences in diarrhea, vomiting, myelosuppression and hand foot syndrome between groups(all P＞0.05). Incidence of peripheral neurotoxicity in the observation group was significantly lower than that in the control group［12.7%(7/55) vs 32.7%(18/55)］（P＜0.05）. Conclusion    Hepatic arterial infusion of oxaliplatin combined with oral capecitabine treating colorectal cancer with liver metastasis can effectively improve 1-year survival rate and prolong PFS time without rising adverse reactions.