摘要：
Objective To explore the clinical efficacy of vinorelbine combined with leucovorin and oxaliplatin chemotherapy for colorectal cancer and its effect on quality of life.Methods 60 patients with colorectal cancer were divided into the control group and the observation group according to the digital method.The control group were treated with oxaliplatin on the first day,and leucovorin and micro pump intravenous drip of 5-fluorouracil from day 1 to day 5;the observation group based on the control group received vinorelbine.Changes of liver function and blood routine were observed during chemotherapy,and the curative effect was evaluated by enhancing CT,MRI NMR and carcinoembryonic antigen review etc.Results Effective rate of the observation group was 83.33％,which was significantly higher than that of the control group,73.33％ (P ＜ 0.05).Within 6 months of treatment,local control rates,survival rates and distant metastasis rates of the 2 groups had no significant difference (P ＞0.05);within 1 ～ 2 year of treatment,local control rate,survival rate and distant metastasis rate of the observation group were significantly better than the control group (P ＜ 0.05).Before treatment,Karnofsky score of the 2 groups had no significant difference (P ＞ 0.05);after treatment,Karnofsky score of the observation group was significantly better than that of the control group,the difference was statistically significant (P ＜ 0.05).In the process of treating patients,adverse reactions were nausea and vomiting,leukopenia,diarrhea,renal toxicity and neurotoxicity,but the incidence of nausea and vomiting 17 (56.67％),leukopenia 11 (36.67％),renal toxicity 3 (10.00％),diarrhea 10 (33.33％) and neurotoxicity 12 (40.00％) of the observation group were significantly lower than the control group,nausea and vomiting 22 (73.33％),leukopenia 16 (53.33％),renal toxicity 7 (23.33 ％),diarrhea 13 (43.33 ％) and neurotoxicity 15 (50.00％) (P ＜ 0.05).Conclusion Vinorelbine combined with leucovorin and oxaliplatin for colon cancer could improve the short-term efficacy and quality of life of patients after treatment,reduce the incidence of adverse reactions,it is worthy of clinical application.%目的 探讨盖诺联合亚叶酸钙与奥沙利铂化疗对结直肠癌患者的临床疗效及生活质量的影响.方法 将60例结直肠癌患者按数字法分为对照组和观察组.对照组患者第1天接受奥沙利铂治疗,第1-5天接受亚叶酸钙及微量泵点滴5-氟尿嘧啶的治疗;观察组患者在对照组治疗的基础上增加盖诺用药.观察患者在化疗过程中的肝脏功能及血常规的变化,并通过增强CT、核磁共振MRI及复查癌胚抗原等进行疗效评价.结果 观察组患者治疗的有效率为83.33％,明显高于对照组治疗的有效率73.33％ (P ＜0.05).在治疗6个月内,2组患者的局部控制率、生存率及远处转移率无明显差别(P＞0.05);但治疗1～2年,观察组患者的局部控制率、生存率及远处转移率明显优于对照组(P＜0.05).2组患者治疗前,Kamofsky评分的评分情况无显著性差别(P＞0.05);治疗后,观察组患者的Kamofsky评分的得分情况明显优于对照组(P＜0.05).患者在治疗过程中,均有恶心呕吐、白细胞下降、肾毒性、腹泻及神经毒性等不良反应发生,但观察组恶心呕吐17例(56.67％)、白细胞下降11例(36.67％)、肾毒性3例(10.00％)、腹泻10例(33.33％)及神经毒性12例(40.00％)的发生率明显低于对照组恶心呕吐22例(73.33％)、白细胞下降16例(53.33％)、肾毒性7例(23.33％)、腹泻13例(43.33％)及神经毒性15例(50.00％)(P＜0.05).结论 采用盖诺联合亚叶酸钙与奥沙利铂治疗结肠癌,可以提高近期疗效,改善患者治疗后的生活质量,减少患者不良反应发生情况,值得临床积极采纳.
