雷替曲塞奥沙利铂肝动脉灌注栓塞与静脉给药治疗结直肠癌肝转移的疗效及安全性比较

摘要

目的：比较雷替曲塞奥沙利铂肝动脉灌注栓塞与静脉给药治疗结直肠癌肝转移的疗效及安全性。方法：采用非盲法随机对照试验。试验组24例，雷替曲塞奥沙利铂肝动脉灌注栓塞，雷替曲塞3mg／m2肝动脉灌注化疗15min 以上，奥沙利铂130mg／m2、碘化油（5～12）ml 混合为混悬液进行栓塞10～15min，28天为1周期；对照组24例：雷替曲塞3mg／m2，静脉滴注，15min 以上，d1，奥沙利铂130mg／m2，静脉滴注，4h，d1，28天为1 周期。结果：试验组 CR ＋PR 66．6％，TTP 10．5个月，对照组 CR ＋PR 45．8％，TTP 4．5个月，两组相比差异有统计学意义（P ＜0．05）；两组在毒副反应方面主要为血液学毒性和消化道反应，试验组优于对照组。结论：雷替曲塞奥沙利铂肝动脉灌注栓塞治疗结直肠癌肝转移相对于全身化疗毒副反应轻，其疗效确切是安全有效的一种治疗方案。%Objective:To compare raltitrexed and oxaliplatin transcatheter hepatic arterial chemoembolization and venous curative for liver metastasis of colorectal cancer.Methods:To use non blinded randomized controlled trial,24 cases were in test group trated by raltitrexed oxaliplatin combined with transcatheter hepatic arterial chemoemboliza-tion,raltitrexed 3mg/m2 hepatic artery infusion chemotherapy of oxaliplatin 130mg/m2 above 15min,(5 ~12)ml mixed into mixed lipiodol embolization of 10 ~15min suspension,28days for 1 cycles.The control group 24 cases were treated by raltitrexed 3mg/m2 ,intravenous drip,15min above d1 ,oxaliplatin,130mg/m2 ,IV drip,4h,d1 ,28days for 1 cycle.Results:In experimental group CR +PR was 66.6%,TTP 10.5 months,CR +PR was 45.8%,in control group,TTP 4.5 months,there was significant difference between two groups(P <0.05).In two groups adverse reac-tions mainly were hematological toxicity and gastrointestinal reaction,the test group was better than control group. Conclusion:Raltitrexed and oxaliplatin combined with hepatic arterial infusion and embolization in treatment of liver metastasis of colorectal cancer toxicity of chemotherapy is light,its a safe and effective treatment.