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目的探讨雷替曲塞联合奥沙利铂(RALOX方案)与5-氟尿嘧啶+亚叶酸钙+奥沙利铂(FOLFOX 4方案)对中晚期原发性肝癌(PLC)的疗效及药物毒性反应。方法选取72例中晚期PLC患者,随机分为RALOX组(n=34)与FOLFOX 4组(n=38)。化疗后每6周评价客观疗效,观察客观缓解率(OR)、疾病控制率(DCR)、中位生存期(mOS)、中位无进展生存期(mPFS)、1年存活率(SR)及毒副反应。结果 RALOX组可评价31例,OR为19.4%,DCR为51.6%,mOS为7.2个月,mPFS为3.4个月,1年SR为22.6%;FOLFOX 4方案组可评价29例,OR为13.8%,DCR为48.3%,mOS为6.9个月,mPFS为3.3个月,1年SR为20.7%,2组差异无有统计学意义(P>0.05)。RALOX组消化道反应、肝毒性、心脏毒性、外周神经毒性及手足综合征的发生率均低于FOLFOX 4组,肾毒性、骨髓抑制的发生率2组相当。结论 RALOX方案应用于中晚期PLC患者安全有效,疗效不劣于FOLFOX 4方案且副反应较轻。
Objective To investigate the efficacy and drug toxicity of raltitrexed combined with oxaliplatin (RALOX) and 5-fluorouracil plus leucovorin plus oxaliplatin (FOLFOX 4) in the treatment of advanced primary hepatocellular carcinoma (PLC). Methods Seventy-two patients with advanced PLC were randomly divided into RALOX group (n = 34) and FOLFOX 4 group (n = 38). The objective curative effect was evaluated every 6 weeks after chemotherapy. The objective response rate (OR), disease control rate (DCR), median survival time (mOS), median progression-free survival time (mPFS), 1 year survival rate Toxic reaction. Results In the RALOX group, 31 cases were evaluated with OR of 19.4%, DCR of 51.6%, mOS of 7.2 months, mPFS of 3.4 months and 1-year SR of 22.6%, and FOLFOX 4 regimen of 29 cases with OR of 13.8% , DCR was 48.3%, mOS was 6.9 months, mPFS was 3.3 months, 1 year SR was 20.7%, there was no significant difference between the two groups (P> 0.05). RALOX group gastrointestinal reactions, hepatotoxicity, cardiotoxicity, peripheral neurotoxicity and the incidence of hand-foot syndrome were lower than FOLFOX 4 group, nephrotoxicity, the incidence of bone marrow suppression was similar in the two groups. Conclusion The RALOX regimen is safe and effective for patients with PLC in the middle and late stages. The efficacy is not inferior to the FOLFOX 4 regimen and the side effects are mild.