国际肿瘤学杂志

国际肿瘤学杂志 ›› 2017, Vol. 44 ›› Issue (12): 897-901.doi: 10.3760/cma.j.issn.1673-422X.2017.12.004

• 论著 • 上一篇    下一篇

奥沙利铂联合雷替曲塞对比替吉奥治疗 中晚期肝癌的研究

林德帅,沈永奇,韩朝稳,黄军,陈超庭,斯韬,王志祥,谢华东,孔祥应   

  1. 545007 柳州，广西医科大学附属柳铁中心医院肿瘤科（林德帅、沈永奇、韩朝稳）；贵阳中医学院第三附 属医院肿瘤科（黄军、孔祥应）；广西科技大学第二附属医院化疗二科（陈超庭）；广西中医药大学第三附属医院肿瘤二 科（斯韬），肿瘤一科（王志祥）；广西壮族自治区柳州市融水县人民医院肿瘤科（谢华东）
  • 出版日期:2017-12-08 发布日期:2017-12-01
  • 通讯作者: 沈永奇，Email: gxnnsyq@163.com E-mail:gxnnsyq@163.com
  • 基金资助:
    广西壮族自治区卫生厅自筹经费科研课题(Z2014408)；柳州市科技攻关项目(2014J030424)

Clinical study of raltitrexed plus oxaliplatin compared with S1 in treating the patients with advanced primary liver cancer

Lin Deshuai*, Shen Yongqi, Han Chaowen, Huang Jun, Chen Chaoting, Si Tao, Wang Zhixiang, Xie Huadong, Kong Xiangying   

  1. Lin Deshuai*, Shen Yongqi, Han Chaowen, Huang Jun, Chen Chaoting, Si Tao, Wang Zhixiang, Xie Huadong, Kong Xiangying. *Department of Oncology, Guangxi Medical University Affili-ated Liutie Central Hospital, Liuzhou 545007, China
  • Online:2017-12-08 Published:2017-12-01
  • Contact: Shen Yongqi, Email: gxnnsyq@163.com E-mail:gxnnsyq@163.com
  • Supported by:
    Research Topic of Self-financing of the Health Department of Guangxi Zhuang Autonomous Region (Z2014408); Scientific and Technological Project of Liuzhou (2014J030424)

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摘要： 目的观察雷替曲塞联合奥沙利铂(RALOX方案)和替吉奥（S1）单药对中晚期原发性肝癌的疗效及不良反应。方法将6个肿瘤中心2013年7月至2015年7月接诊的共71例中晚期原发性肝癌，按患者及家属的治疗意愿分为两组：RALOX方案组（34例）和S1单药组（37例）。评价两组客观缓解率（ORR）、疾病控制率(DCR)、中位总生存时间(mOS)、中位无进展生存时间（mPFS）、1年存活率（SR）以及不良反应。结果RALOX方案组可评价31例，其中部分缓解（PR）6例，稳定（SD）10例，进展（PD）15例，S1单药组可评价33例，其中PR 3例，SD 8例，PD 22例。两组的ORR（19.4%∶9.1%）、DCR（51.6％∶33.3%）、1年SR（22.6%∶12.1%）差异无统计学意义（χ2=1.393，P=0.238；χ2=2.190，P=0.139；χ2=1.229，P=0.268）。RALOX方案组mOS（7.2个月∶6.1个月）、mPFS（3.4个月∶2.8个月）较S1单药组明显延长，差异有统计学意义（χ2=6.433，P=0.011；χ2=4.078，P=0.043）。RALOX方案组的周围神经毒性比S1单药组严重（29.0%∶3.0%，χ2=6.344，P=0.012），但手足综合征较轻（9.7%∶30.3%，χ2=4.201，P=0.040），其他不良反应两组大致相当。结论RALOX方案对中晚期原发性肝癌安全有效，疗效优于S1单药方案，多数患者不良反应较轻，对患者有良好的病情控制和生存获益。

关键词: 肝肿瘤, 铂化合物, 抗代谢药, 抗肿瘤, 替吉奥

Abstract: ObjectiveTo evaluate the therapeutic efficacy and adverse reactions of raltitrexed plus oxaliplatin (RALOX project) and S1 in patients with advanced primary liver cancer. MethodsSeventy-one patients with advanced primary liver cancer admitted to 6 cancer centers from July 2013 to July 2015 were divided into 2 groups according to the wishes of the patients and their families: RALOX group (34 patients) and S1 group (37 patients). The therapeutic efficacy such as objective remission rate (ORR), disease control rate (DCR), median overall survival (mOS), median progression free survival (mPFS), one year survival rate (SR), and adverse reactions in these patients were evaluated. ResultsThirty-one patients could be evaluated in RALOX group, and 6 patients obtained partial response (PR), 10 stable disease (SD) and 15 progressive disease (PD). Thirty-three patients could be evaluated in S1 group, and 3 patients obtained PR, 8 patients SD and 22 PD. The ORR, DCR, and one year SR were 19.4% vs. 9.1%, 51.6% vs. 33.3%, and 22.6% vs. 12.1% respectively, and there were no statistically significant differences in the two groups (χ2=1.393, P=0.238; χ2=2.190, P=0.139; χ2=1.229, P=0.268). The mOS and mPFS were 7.2 months vs. 6.1 months and 3.4 months vs. 2.8 months, and there were statistically significant differences in the two groups (χ2=6.433, P=0.011; χ2=4.078, P=0.043). There was more serious peripheral nerve toxicity (29.0% vs. 3.0%, χ2=6.344, P=0.012) and lighter hand-foot syndrome (9.7% vs. 30.3%, χ2=4.201, P=0.040) in RALOX group than S1 group. But the incidences of other adverse effects were similar in the two groups. ConclusionRALOX project is safe and effective to the patients with advanced primary liver cancer. Compare with S1 project, RALOX project has better curative effects and the majority of adverse reactions are tolerable. The patients have good condition control and survival benefit.

Key words: Liver neoplasms, Platinum compounds, Antimetabolites, antineoplastic, S1