全反式维甲酸联合化疗治疗晚期结肠癌临床观察

目的:探讨全反式维甲酸联合化疗治疗晚期结肠癌的临床疗效和安全性。方法:将2009年4月至2012年3月我院收治的178例晚期结肠癌患者随机分入试验组(全反式维甲酸联合m FOLFOx6方案化疗)和对照组(单纯m FOLFOx6方案化疗),每组89例。治疗后,观察和比较两组患者的近期疗效、疾病进展时间、总生存期、KPS评分改善情况和不良反应的发生情况。结果:试验组的近期有效率为67.8%,对照组为50.6%,显著低于试验组(P=0.021);试验组患者的KPS评分改善率为79.3%,而对照组为57.4%,显著低于试验组(P=0.002)。试验组患者的中位生存期和中位疾病进展期分别为14.784、7.502个月;对照组患者分别为13.12、6.244个月,均较试验组显著缩短(P0.05)。试验组患者恶心呕吐的发生率显著低于对照组(P=0.016),两组其它不良反应如骨髓抑制、肝肾功能损害、心脏毒性等的发生率比较差异无统计学意义(P0.05)。结论:全反式维甲酸注射液联合化疗治疗晚期结肠癌可以提高其临床疗效,延长其生存期,改善其生存质量,且能减轻消化道不良反应。

Clinical Observation on Chemotherapy Plus All-trans Retinoid Acid in the Treatment of Advanced Colon Carcinoma

Objective:To evaluate the clinical efficacy and safety of all-trans retinoid acid combined with chemotherapy in the treatment of advanced colon carcinoma.Methods:One hundred and seventy-eight patients with advanced colon carcinoma who were treated in our hospital from April 2009 to March 2012 were recruited in this study. They were randomly assigned into two groups: study group (n=89; receiving all-trans retinoid acid plus mFOLFOx6) and control group(n=89; receiving mFOLFOx6). The short-term clinical efficacy, time to progress (TTP) and overall survival (OS), change of Karnofsky performance status score and incidence of adverse reactions were observed and compared between two groups.Results:The short-termresponse rates of study group and control group were respectively 67.8%, 50.6%, which was significantly lower in the control group than that of the study group (P=0.021). The improvement rate of KPS score of study group was 79.3%, which was significantly lower than that of study group(57.4%, P=0.002). The median survival time and median time to progress of study group were 14.784, 7.502 months, while those of control group were 13.12, 6.244 months, which were both shorter than those of the study group(P<0.05). The prevalence of nausea/vomiting of study group was significantly lower than that of control group (P=0.016). No significant difference was found in the other toxicity such as bone marrow suppression , liver dysfunction, renal dysfunction, Heart toxic reaction between the two groups was not statistically significant (P>0.05).Conclusion:All-trans retinoid acid combined with chemotherapy could improve the clinical efficacy of advanced colon carcinoma, lead to a better survival time, a superior quality of life and had less nausea/vomiting prevalence.