【摘要】：目的:探討FOLFOX6與FOLFIRI在潛在可切除結(jié)直腸癌肝轉(zhuǎn)移轉(zhuǎn)化治療中的臨床療效。方法:采用回顧性分析的方法,根據(jù)納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn),收集我院2010年1月至2016年1月接受FOLFOX6與FOLFIRI轉(zhuǎn)化治療的潛在可切除結(jié)直腸癌肝轉(zhuǎn)移患者的病歷資料,分析其轉(zhuǎn)化療效,對比兩組化療方案轉(zhuǎn)化治療病人的疾病控制率(DCR)、客觀緩解率(RR)、根治性手術(shù)率(R0切除率)以及患者1年生存情況。結(jié)果:1、根據(jù)納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn),共收集到符合研究標(biāo)準(zhǔn)的潛在可切除結(jié)直腸癌肝轉(zhuǎn)移患者病歷資料98例,其中,男76例(77.6%),女22例(22.4%),≥45歲75例(76.5%),45歲23例(23.5%),平均年齡為52.41±12.729歲,使用FOLFOX6方案轉(zhuǎn)化化療71例(72.4%),FOLFIRI方案27例(27.6%),結(jié)腸癌38例(38.8%),直腸癌60例(61.2%)。2、在接受FOLFOX6方案行轉(zhuǎn)化化療的71例患者中,男53例(74.6%),女18例(25.4%);接受FOLFIRI方案行轉(zhuǎn)化化療的27例患者中,男23例(85.2%),女4例(14.8%);FOLFOX6組RR、DCR分別為33.8%、96.4%,而FOLFIRI組RR、DCR分別為29.6%、88.9%,兩組的化療反應(yīng)率相近,差異有無統(tǒng)計學(xué)意義(P0.05)。3、本組患者經(jīng)轉(zhuǎn)化化療后有32例獲根治性手術(shù)切除,其中FOLFOX6組22例,FOLFIRI組10例,FOLFOX6組R0切除率為31%,FOLFIRI組R0切除率為37%,差異無統(tǒng)計學(xué)意義(χ~2=0.326,P=0.5680.05)。4、轉(zhuǎn)化化療的不良反應(yīng)主要表現(xiàn)在血液系統(tǒng)(白細(xì)胞、血小板減少)、消化系統(tǒng)(惡心/嘔吐、腹瀉)、神經(jīng)系統(tǒng)(周圍神經(jīng)炎),多數(shù)為I-III級,未出現(xiàn)IV級不良反應(yīng)。FOLFOX6組患者的血液系統(tǒng)毒性與FOLFIRI組相比未見明顯差異(P0.05)。FOLFIRI組患者化療引起的神經(jīng)系統(tǒng)毒性輕于FOLFOX6組(P0.05);FOLFIRI組以惡心/嘔吐、腹瀉為主的消化系統(tǒng)不良反應(yīng)顯著重于FOLFOX6組(P0.05)。5、本研究共隨訪94例患者,失訪4人,失訪患者中包括FOLFOX6組3人,FOLFIRI組1人,隨訪率為95.9%(94/98)。FOLFOX6組獲隨訪的68例患者的1年生存率分別為73.5%(50/68),FOLFIRI組獲隨訪的26例患者的1年生存率分別為80.8%(21/26)。FOLFOX6組與FOLFIRI組的1年生存率比較均未見顯著差異性(P0.05)。通過Kaplan-Meier法進(jìn)行生存分析,兩組患者的生存時間對比無統(tǒng)計學(xué)差異(χ~2=3.153,P=0.0760.05)。結(jié)論:1、轉(zhuǎn)化化療應(yīng)用于潛在可切除的結(jié)直腸癌肝轉(zhuǎn)移患者,可使部分患者的肝轉(zhuǎn)移灶縮小,提高根治性手術(shù)切除率,改善患者預(yù)后,且不良反應(yīng)均可耐受,是一種安全、有效的轉(zhuǎn)化治療方法。2、對潛在可切除結(jié)直腸肝轉(zhuǎn)移患者行轉(zhuǎn)化化療,FOLFOX6與FOLFIRI療效相近,兩者不良反應(yīng)各有側(cè)重,FOLFOX6方案出現(xiàn)的不良反應(yīng)以神經(jīng)系統(tǒng)毒性為主,而FOLFIRI方案出現(xiàn)的不良反應(yīng)以消化系統(tǒng)毒性為主。
[Abstract]:Objective: to evaluate the clinical efficacy of FOLFOX6 and FOLFIRI in the treatment of liver metastasis from potentially resectable colorectal cancer. Methods: by retrospective analysis, according to the inclusive and exclusion criteria, the medical records of patients with liver metastasis from FOLFOX6 and FOLFIRI were collected from January 2010 to January 2016, and the therapeutic effects were analyzed. The (DCR), objective remission rate (RR), radical resection rate) and the survival rate of the patients in one year were compared between the two groups. Results: 1. According to the inclusion criteria and exclusion criteria, 98 patients with liver metastases from potentially resectable colorectal cancer were collected, including 76 males (77.6%), 22 females (22.4%), 75 cases (76.5%) 鈮，

本文編號：2281601