[1]王 珺,梁淑影,单争争,等.雷替曲塞二线治疗晚期结直肠癌的疗效分析*[J].郑州大学学报(医学版),2017,(03):317-321.[doi:10.13705/j.issn.1671-6825.2017.03.019]
 WANG Jun,LIANG Shuying,SHAN Zhengzheng,et al.Therapeutic effect of raltitrexed as second-line treatment for advanced colorectal cancer[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(03):317-321.[doi:10.13705/j.issn.1671-6825.2017.03.019]
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雷替曲塞二线治疗晚期结直肠癌的疗效分析*()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年03期
页码:
317-321
栏目:
应用研究
出版日期:
2017-05-15

文章信息/Info

Title:
Therapeutic effect of raltitrexed as second-line treatment for advanced colorectal cancer
作者:
王 珺梁淑影单争争王留兴樊青霞王 峰#
郑州大学第一附属医院肿瘤科 郑州 450052
Author(s):
WANG Jun LIANG Shuying SHAN Zhengzheng WANG Liuxing FAN Qingxia WANG Feng
Department of Oncology,the First Affiliated Hospital, Zhengzhou University,Zhengzhou 450052
关键词:
雷替曲塞 晚期结直肠癌 二线治疗
Keywords:
raltitrexed advanced colorectal cancer second-line treatment
分类号:
R735.3
DOI:
10.13705/j.issn.1671-6825.2017.03.019
摘要:
目的:观察雷替曲塞联合奥沙利铂二线治疗晚期结直肠癌的临床疗效及安全性。方法:收集郑州大学第一附属医院收治的经一线治疗失败的晚期结直肠癌患者57例,采用随机数字表法分为2组。28例采用TOMOX方案治疗,29例采用FOLFOX4方案治疗,评价2组疗效及不良反应。结果:TOMOX组和FOLFOX4组有效率分别为14.3%(4/28)和10.3%(3/29),疾病控制率分别为78.6%(22/28)和82.7%(24/29)(P>0.05)。TOMOX组的无疾病进展生存期(PFS)为8.30个月,FOLFOX4组的PFS为8.10个月; TOMOX组的总生存期(OS)为15.40个月,FOLFOX4组的OS为14.10个月(P>0.05)。TOMOX组中性粒细胞减少及心脏毒性的发生率低于FOLFOX4组,而TOMOX组转氨酶升高的发生率较FOLFOX4组高(P<0.05),但多为Ⅰ~Ⅱ级,可耐受。结论:雷替曲塞联合奥沙利铂二线治疗晚期结直肠癌的疗效确切,且具有不良反应轻、易耐受等特点。
Abstract:
Aim: To observe the efficacy and safety of raltitrexed plus oxaliplatin in the treatment of advanced colorectal cancer as the second-line treatment.Methods: A total of 57 advanced colorectal cancer patients with failed first-line chemotherapy were randomized into two groups,28 patients treated with TOMOX and 29 patients treated with FOLFOX4. The differences in treatments effect and adverse reaction between the two groups were compared.Results: The response rates were 14.3%(4/28)in TOMOX group and 10.3%(3/29)in FOLFOX4 group, the disease control rates were 78.6%(22/28)in TOMOX group and 82.7%(24/29)in FOLFOX4 group(P>0.05).The progression-free survival was 8.30 and 8.10 months for TOMOX group and FOLFOX4 group,and the overall survival was 15.40 and 14.10 months,respectively(P>0.05).The patients in TOMOX group had significantly lower incidence of neutropenia and cardiotoxicity,while the incidence of hepatic disorder was higher,which was endurable,however(P<0.05).Conclusion: Raltitrexed combined with oxaliplatin is more effective with less side effect as the second-line treatment for advanced colorectal cancer.

参考文献/References:

[1] DESANTIS CE,LIN CC,MARIOTTO AB,et al.Cancer treatment and survivorship statistics,2014[J].CA Cancer J Clin,2014,64(4):252
[2] VAN CUTSEM E,TABERNERO J,LAKOMY R,et al.Addition of aflibercept to fluorouracil, leucovorin, and irinotecan improves survival in a phase Ⅲ randomized trial in patients with metastatic colorectal cancer previously treated with an oxaliplatin-based regimen[J].J Clin Oncol,2012,30(28):3499
[3] TOURNIGAND C,ANDRÉ T,ACHILLE E,et al.FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study[J].J Clin Oncol,2004,22(2):229
[4] MAINDRAULT-GOEBEL F,LOUVET C,ANDRÉ T,et al.Oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as second-line therapy for metastatic colorectal cancer(FOLFOX6):GERCOR[J].Eur J Cancer,1999,35(9):1338
[5] ENGSTROM PF,ARNOLETTI JP,BENSON AB,et al.NCCN clinical practice guidelines in oncology:colon cancer[J].J Natl Compr Canc Netw,2009,7(8):778
[6] GRAVALOS C,SALUT A,GARCÍA-GIRÓN C,et al.A randomized phase Ⅱ study to compare oxaliplatin plus 5-fluorouracil and leucovorin(FOLFOX4)versus oxaliplatin plus raltitrexed(TOMOX)as first-line chemotherapy for advanced colorectal cancer[J].Clin Transl Oncol,2012,14(8):606
[7] BARNI S,GHIDINI A,COINU A,et al.A systematic review of raltitrexed-based first-line chemotherapy in advanced colorectal cancer[J].Anticancer Drugs,2014,25(10):1122
[8] RUERS T,BLEICHRODT RP.Treatment of liver metastases, an update on the possibilities and results[J].Eur J Cancer,2002,38(7):1023
[9] 李宇杰,车向明,甘建新,等.同时性结直肠癌肝转移同期与分期手术疗效的Meta分析[J].西安交通大学学报(医学版),2012,33(3):365
[10]GALLAGHER DJ,KEMENY N.Metastatic colorectal cancer: from improved survival to potential cure[J].Oncology,2010,78(3/4):237
[11]YONEY A,ASKAROGLU B,HANCILAR T,et al.A retrospective comparison of concurrent bolus 5-fluorouracil or raltitrexed in preoperative chemoradiation for locally advanced rectal cancer[J].Hematol Oncol Stem Cell Ther,2010,1(1):28
[12]WILSON KS,FITZGERALD CA,BARNETT JB,et al.Adjuvant therapy with raltitrexed in patients with colorectal cancer intolerant of 5-fluorouracil: British Columbia Cancer Agency experience[J].Cancer Invest,2007,25(8):711
[13]SANTINI D,MASSACESI C,D'ANGELILLO RM,et al.Raltitrexed plus weekly oxaliplatin as first-line chemotherapy in metastatic colorectal cancer: a multicenter non-randomized phase Ⅱ study[J].Med Oncol,2004,21(1):59
[14]POPOV I,CARRATO A,SOBRERO A,et al.Raltitrexed(Tomudex)versus standard leucovorin-modulated bolus 5-fluorouracil:results from the randomised phase Ⅲ Pan-European Trial in Adjuvant Colon Cancer 01(PETACC-1)[J].Eur J Cancer,2008,44(15):2204
[15]RAYMOND E,FAIVRE S,WOYNAROWSKI JM,et al.Oxaliplatin: mechanism of action and antineoplastic activity[J].Semin Oncol,1998,25(2 Suppl 5):4
[16]FARRUGIA DC,FORD HE,CUNNINGHAM D,et al.Thymidylate synthase expression in advanced colorectal cancer predicts for response to raltitrexed[J].Clin Cancer Res,2003,9(2):792
[17]ZALCBERG JR,CUNNINGHAM D,VAN CUTSEM E,et al.ZD1694:a novel thymidylate synthase inhibitor with substantial activity in the treatment of patients with advanced colorectal cancer. Tomudex Colorectal Study Group[J].J Clin Oncol,1996,14(3):716
[18]VAN CUTSEM E,CUNNINGHAM D,MAROUN J,et al.Raltitrexed: current clinical status and future directions[J].Ann Oncol,2002,13(4):513
[19]LIU Y,WU W,HONG W,et al.Raltitrexed-based chemotherapy for advanced colorectal cancer[J].Clin Res Hepatol Gastroenterol,2014,38(2):219
[20]CORTINOVIS D,BAJETTA E,DI BARTOLOMEO M,et al.Raltitrexed plus oxaliplatin in the treatment of metastatic colorectal cancer[J].Tumori,2004,90(2):186
[21]CASCINU S,GRAZIANO F,FERRAÙ F,et al.Raltitrexed plus oxaliplatin(TOMOX)as first-line chemotherapy for metastatic colorectal cancer:a phase Ⅱ study of the Italian Group for the Study of Gastrointestinal Tract Carcinomas(GISCAD)[J].Ann Oncol,2002,13(5):716
[22]SCHEITHAUER W,KORNEK GV,SCHUELL B,et al.Second-line treatment with oxaliplatin+raltitrexed in patients with advanced colorectal cancer failing fluoropyrimidine/leucovorin-based chemotherapy[J].Ann Oncol,2001,12(5):709

备注/Memo

备注/Memo:
*河南省教育厅科学技术研究重点项目 13A320638
#通信作者,男,1974年10月生,博士,副教授,研究方向:消化道肿瘤基础与临床,E-mail:fengw010@163.com
更新日期/Last Update: 2017-05-20