目的：比较雷替曲塞或5-氟尿嘧啶（5-Fu）/亚叶酸钙(CF)联合奥沙利铂治疗晚期结直肠癌的有效性和安全性。方法经病理组织学确诊的晚期结直肠癌患者40例，随机分入治疗组和对照组。治疗组：雷替曲塞3 mg/m 2 d 1；奥沙利铂130 mg/m 2 d 1。对照组：亚叶酸钙200 mg/m 2 d 1-5；氟尿嘧啶375 mg/m 2 d 1-5；奥沙利铂130 mg/m 2 d 1。两方案均以21 d为1周期，每2个周期评价疗效及不良反应。结果治疗组和对照组的有效率分别为45.0%(9/20)和15.0%(3/20)，两组间比较差异有统计学意义（P＜0.05）。临床获益率比较，两组分别是80.0%(16/20)和50.0%（10/20），两组间比较差异有统计学意义（P＜0.05）。治疗组转氨酶升高率高于对照组，对照组呕吐发生率高于治疗组，但均无明显差异（P＞0.05）。结论雷替曲塞联合奥沙利铂治疗晚期结直肠癌安全、有效。%Objective To assess the efficacy and safety of oxaliplatin plus raltitrexed with oxaliplatin plus fluorouracil and leucovorin for advanced colorectal cancer. Methods 40 cases of advanced colorectal cancer confirmed by pathology were randomly assigned to treatment group and control group. Treatment group:raltitrexed 3 mg/m 2d 1;oxaliplatin 130 mg/m 2d 1. Control group:leucovorin 200 mg/m 2d 1-5;fluorouracil 375 mg/m 2 d 1-5;oxaliplatin 130 mg/m 2 d 1. The two regiments were 21 days as a cycle. The efficacy and safety were evaluated after two cycles. Results In the treatment group, the effective rate 45.0%(9/20) and clinical beneficial rate 80.0%(16/20) were significantly higher than those of the control group respectively (P<0.05).The elevated transaminase enzymes in the treatment group was higher than that in the control group and the vomiting was lower than that in the control group. There was no significant difference between the two groups(P>0.05). Conclusion Raltitrexed combined with oxaliplatin is safe and effective in the treatment of advanced colorectal cancer.
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