重组人血管内皮抑制素联合化疗一线治疗晚期转移性结直肠癌的疗效观察

摘要

目的：探讨重组人血管内皮抑制素（恩度）联合化疗一线治疗晚期转移性结直肠癌的疗效及安全性。方法：60例晚期转移性结直肠癌分为试验组（ n＝30）和对照组（ n＝30），对照组采用FOLFOX4化疗方案，试验组采用恩度联合FOLFOX4方案。结果：试验组和对照组获得的有效率（ RR）分别为53.3％和36.7％（ P<0.05），疾病控制率（DCR）为83.3％和73.3％（P<0.05），两组患者的中位无进展生存期（PFS）分别为7.3个月和5.3个月（P<0.05），中位总生存时间（OS）分别为11.6个月和9.3个月（P<0.05）。对其中的27例肝转移患者进行亚组分析，试验组和对照组RR及DCR比较差异均有统计学意义（ P<0.05），但是PFS及OS无统计学意义（ P>0.05）。主要不良反应为血液学毒性、消化道反应、神经毒性等，多为I-II级。两组患者经化疗后QOL均得到较大程度的改善；与治疗前相比，治疗后CEA和CA199均显著下降，且治疗后试验组下降较对照组更明显（ P<0.05）。结论：恩度联合化疗一线治疗晚期转移性结直肠癌安全有效。%Objective:To analyze the efficacy and safety of Rh-endostatin( endostar)combined with chemothera-py in the treatment of metastatic colorectal cancer. Methods:All 60 metastatic colorectal cancer patients were divided into the test group(n=30)and the control group(n=30). The control group was treated with chemotherapy regimen FOLFOX4,the test group was treated by Endostar combined with FOLFOX4 scheme. Results:The response rates were 53. 3% in test group and 36. 7% in control group respectively(P<0. 05),the disease control rate were 83. 3% and 73. 3%(P<0. 05). The median progression -free survival in test group and control group were 7. 3 months ver-sus 5. 3 months(P<0. 05)and median overall survival were 11. 6 months versus 9. 3 months(P<0. 05). Among 27 cases of liver metastases were sub group analysis,difference on the test group and the control group RR and DCR had statistical significance(P<0. 05),but difference on PFS and OS had no statistical significance(P>0. 05). The major toxicities were myelosuppression,gastrointestinal symptoms,neurotoxicity,most in grade I -II. After chemotherapy, QOL of patients were more improved than before treatment. After treatment the CEA and CA199 levels decreased obvi-ously,furtheremore,the test group decreased more obviously than the control group. Conclusion:Rh-endostatin com-bined with chemotherapy in the treatment of metastatic colorectal cancer is safe and effective,and also improves pro-gression-free survival.