替吉奥联合奥沙利铂与卡培他滨联合奥沙利铂方案治疗结直肠癌的疗效比较研究

摘要

Objective To compare the clinical efficacy and side effects of postoperative chemotherapy of S-1 combined with oxaliplatin (SOX) with those of capecitabine combined with oxaliplatin (XELOX) in the treatment of colorectal cancer.Methods A total of 92 patients with colorectal cancer treated in the General Hospital of PLA from 2008 to 2013 were selected and divided into the treatment group (50 cases) receiving postoperative 8 cycles of SOX chemotherapy and control group (42 cases) receiving postoperative 8 cycles of XELOX chemotherapy by drawing lot.The follow-up was carried out from starting chemotherapy to December 31st,2016 with death as the end event by regular telephone or correspondence.The occurrence and severity of side effects (myelosuppression,digestive tract reactions,toxicity in heart,liver and kidney,peripheral neuritis,hyperpigmentation) during chemotherapy were recorded.Results During the follow-up period,the recurrence or metastasis rate in the treatment group was similar to that in the control group [30.0％ (15/50) vs.31.0％ (13/42)] (x2 =2.513,P =0.816).The median survival time in the treatment group and the control group was 24.2 and 25.6 months respectively,and there was no significant difference between the two groups in the survival curve (x2 =1.005,P =0.601).There were no significant differences in the incidence of digestive tract reactions,toxicity in heart,liver and kidney,peripheral neuritis and pigmentation between the two groups (P ＞ 0.05).No statistically significant differences in the severity were found between the groups in the severity of bone marrow suppression,digestive tract reactions,toxicity in heart,liver and kidney,peripheral neuritis,and pigmentation (P ＞ 0.05).Conclusion For colorectal cancer patients,SOX chemotherapy can achieve similar effects as the XELOX chemotherapy does,without increasing or aggravating the incidence and severity of toxic and side effects,so it can be used as an alternative first-line chemotherapy for colorectal cancer.%目的 比较替吉奥联合奥沙利铂方案(SOX方案)与卡培他滨联合奥沙利铂方案(XELOX方案)对结直肠癌患者术后化疗的效果和安全性.方法 选取2008-2013年陆军总医院手术治疗的结直肠癌患者92例为研究对象,采用抽签法,将患者分为治疗组(50例)和对照组(42例).治疗组、对照组术后分别进行8个周期的SOX方案、XELOX方案化疗.以术后开始化疗为观察起点,采用电话或信函方式随访,以死亡为终点事件,随访截至2016-12-31.记录化疗期间毒副作用(骨髓抑制,消化道反应,心脏及肝、肾毒性反应,周围神经炎,色素沉着)的发生及严重程度.结果 随访期间,治疗组复发或转移15例(30.0％),对照组复发或转移13例(31.0％),两组复发或转移发生率比较,差异无统计学意义(x2 =2.513,P=0.816).治疗组、对照组中位生存时间分别为24.2、25.6个月,两组生存曲线比较,差异无统计学意义(x2=1.005,P=0.601).两组消化道反应,心脏及肝、肾毒性反应,周围神经炎,色素沉着发生率比较,差异均无统计学意义(P＞0.05).两组骨髓抑制,消化道反应,心脏及肝、肾毒性反应,周围神经炎,色素沉着严重程度比较,差异均无统计学意义(P＞0.05).结论 结直肠癌患者采用SOX方案化疗可取得与XELOX方案相似的效果,且不增加或加重毒副作用的发生及严重程度,可作为一线结直肠癌备选化疗方案.