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[目的]评价雷替曲塞在治疗晚期结直肠癌肝转移中的疗效和不良反应。[方法]对120例结直肠癌术后肝转移的患者进行化疗,将其随机分为研究组和对照组,每组60例。研究组采用介入下肝动脉灌注雷替曲塞化疗联合栓塞治疗,对照组采用雷替曲塞单药静脉滴注治疗。以上治疗每3周1次。共进行3~6个周期。比较两组的治疗有效率(RR)、疾病控制率(DCR)、中位疾病进展时间、生存率及不良反应情况。[结果]治疗有效率(RR)研究组为38.3%,对照组为20.0%,差异有统计学意义(P=0.027);疾病控制率(DCR)研究组为66.7%,对照组为45.0%,差异有统计学意义(P=0.017)。中位疾病进展时间研究组为15.4个月,对照组为10.5个月,差异有统计学意义(P=0.000)。研究组1、2年生存率分别为71.7%、56.7%,对照组分别为51.7%、38.3%,差异均有统计学意义(P值分别为0.024、0.044)。[结论]介入下肝动脉灌注雷替曲塞化疗联合栓塞治疗结直肠癌肝转移疗效肯定,不良反应能耐受,值得临床推广。
[Objective] To evaluate the efficacy and adverse reactions of raltetracetam in the treatment of advanced liver cancer with colorectal cancer. [Method] A total of 120 patients with postoperative liver metastasis of colorectal cancer were treated with chemotherapy. They were randomly divided into study group and control group, 60 cases in each group. The intervention group was treated with raltitrexed with hepatic arterial infusion and embolization in the study group, and the control group with intravenous infusion of raltitrexed alone. The above treatment every 3 weeks. A total of 3 to 6 cycles. The treatment efficiency (RR), disease control rate (DCR), median disease progression time, survival rate and adverse reactions were compared between the two groups. [Results] The effective rate of treatment was 38.3% in the study group and 20.0% in the control group (P = 0.027). The rate of disease control (DCR) group was 66.7% and that of the control group was 45.0% The difference was statistically significant (P = 0.017). The median progression time was 15.4 months in the study group and 10.5 months in the control group, with a statistically significant difference (P = 0.000). The 1-year and 2-year survival rates of the study group were 71.7% and 56.7%, respectively, and those in the control group were 51.7% and 38.3% respectively. The differences were statistically significant (P = 0.024,0.044, respectively). [Conclusion] The intervention of hepatic arterial infusion of raltitrexed with chemoembolization in the treatment of colorectal cancer with liver metastasis is effective and the side effects can be tolerated. It is worthy of clinical promotion.