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目的观察卡培他滨片治疗老年晚期转移性结直肠癌的临床疗效及安全性。方法将70例老年晚期转移性结直肠癌患者随机分为对照组35例和试验组35例。对照组不接受任何治疗,只定期进行临床观察,直至病情进展再接受进一步治疗;试验组予以卡培他滨1000 mg·m~(-2),bid,饭后口服,连用2周,停用1周。试验组1个周期为21 d,共治疗2个周期。比较2组患者的临床疗效、血管内皮生长因子(VEGF)、糖蛋白抗原199(CA199),癌胚抗原(CEA),以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为77.14%(27/35例)和25.71%(9/35例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的VEGF分别为(53.55±14.03)和(78.34±14.34)pg·m L~(-1),CA199分别为(261.32±69.42)和(376.41±86.65)U·m L~(-1),CEA分别为(16.93±1.06)和(22.64±2.31)ng·m L~(-1),差异均有统计学意义(均P<0.05)。2组患者出现的药物不良反应以白细胞下降、手足综合征、疲劳、恶心呕吐、腹泻为主,试验组和对照组的药物不良反应发生率分别为68.57%和25.71%,差异有统计学意义(P<0.05)。结论卡培他滨片治疗老年晚期转移性结直肠癌的临床疗效确切,但明显提高了药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of capecitabine in the treatment of elderly patients with advanced metastatic colorectal cancer. Methods Seventy patients with advanced metastatic colorectal cancer were randomly divided into control group (35 cases) and experimental group (35 cases). The control group did not receive any treatment, only regular clinical observation until the progression of the disease and then further treatment; test group were given capecitabine 1000 mg · m ~ (2), bid, after meals orally for 2 weeks, deactivation 1 week. One cycle of the experimental group was 21 days, a total of two cycles of treatment. The clinical efficacy, vascular endothelial growth factor (VEGF), glycoprotein antigen 199 (CA199), carcinoembryonic antigen (CEA), and the incidence of adverse drug reactions were compared between the two groups. Results After treatment, the total effective rates of the experimental group and the control group were 77.14% (27/35 cases) and 25.71% (9/35 cases), respectively, with statistical significance (P <0.05). After treatment, the VEGF of the experimental group and the control group were (53.55 ± 14.03) and (78.34 ± 14.34) pg · m L -1, respectively, and the values of CA199 were (261.32 ± 69.42) and (376.41 ± 86.65) U · m L ~ (-1) and CEA were (16.93 ± 1.06) and (22.64 ± 2.31) ng · m L -1, respectively (all P <0.05). Adverse drug reactions occurred in two groups of patients with leukopenia, hand-foot syndrome, fatigue, nausea, vomiting, diarrhea, the incidence of adverse drug reactions in the experimental group and the control group were 68.57% and 25.71%, the difference was statistically significant P <0.05). Conclusions Capecitabine tablet is effective in the treatment of elderly patients with advanced metastatic colorectal cancer, but significantly increases the incidence of adverse drug reactions.