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中国临床药理学与治疗学 ›› 2017, Vol. 22 ›› Issue (6): 674-679.

• 药物治疗学 • 上一篇    下一篇

持续泵注恩度联合化疗新辅助治疗局部晚期直肠癌的对比研究

蒋三亚1,2,单亚兵3,陈文斌1   

  1. 1 浙江大学附属第一医院肛肠科,杭州 310003,浙江;2 杭州市红十字医院肛肠科,杭州 310003,浙江;3 浙江中医药大学附属第三医院肛肠科,杭州 310005,浙江
  • 收稿日期:2016-11-22 修回日期:2017-01-23 出版日期:2017-06-26 发布日期:2017-06-26
  • 通讯作者: 陈文斌,男,博士,主任医师,主要从事肛肠外科基础与临床研究。 Tel:13396553806 E-mail:cwbin@hotmail.com
  • 作者简介:蒋三亚,男,本科,主治医师,主要从事肛肠外科基础与临床研究。 Tel:13456967648 E-mail:fzy0406@163.com
  • 基金资助:

    浙江省医药卫生项目(2012KYB028)

Comparison study of modified FOLFOX6 combined with durative transfusion of endostatin as neoadjuvant treatment vs. treatment without endostatin for locally advanced rectal cancer

JIANG Sanya 1,2, SHAN Yabing 3, CHEN Wenbin 1   

  1. 1 Department of Proctology, the First Affiliated Hospital of Zhejiang University, Hangzhou 310003, Zhejiang, China; 2 Department of Proctology, Red Cross Hospital of Hangzhou, Hangzhou 310000, Zhejiang, China; 3 Department of Proctology, the Third Affiliated Hospital of Zhejiang University of TCM, Hangzhou 310000, Zhejiang, China
  • Received:2016-11-22 Revised:2017-01-23 Online:2017-06-26 Published:2017-06-26

摘要:

目的: 探讨持续泵注重组人血管内皮抑制素(恩度)联合mFOLOFX6方案新辅助治疗局部晚期直肠癌的临床有效率、病理缓解率及安全性。方法: 62例符合入组标准患者被随机分配到mFOLFOX6组(对照组)和恩度联合mFOLFOX6组(试验组)。对照组具体用法:奥沙利铂,85 mg/m2,第1天,静脉滴注2 h;亚叶酸钙,200 mg/m2,第1天,静脉滴注2 h;氟尿嘧啶,0.4 g/m2,静脉推注;氟尿嘧啶,2.6 g/m2,亚叶酸钙滴注结束后,立即持续泵入46 h,每2周重复;试验组具体用法:在mFOLFOX6基础上,恩度7.5 mg·m-2·d-1,每天持续24 h静脉泵入,连续7 d,每2周重复;治疗4到6周期后接受根治性手术。结果: 62例患者一共接受 310个周期的治疗,均可评价疗效;试验组的总有效率为62.5%;对照组为36.6%,试验组的总有效率高于对照组,两组差异有统计学意义(P<0.05);试验组病理完全缓解率为28.1%,对照组为6.7%,试验组的病理完全缓解率高于对照组,两组差异有统计学意义(P<0.05);试验组保肛率为81.3%,对照组为56.7%,试验组的保肛率高于对照组,两组差异有统计学意义(P<0.05);两组的毒性反应较轻,均以Ⅰ、Ⅱ级为主,两组差异无统计学意义(P>0.05);两组患者的手术并发症发生率均较低,两组差异无统计学意义(P>0.05)。结论: 重组人血管内皮抑制素(恩度)联合mFOLOFX6方案新辅助治疗局部晚期直肠癌可以提高总有效率、病理完全缓解率和保肛率,不增加不良反应和并发症,值得临床推广应用。

关键词: 恩度, 直肠癌, 新辅助治疗, 病理缓解率, 疗效, 毒性反应

Abstract:

AIM: To investigate the clinical efficacy, pathological remission rate and safety of mFOLOFX6 regimen combined with durative transfusion recombinant human endostatin as neoadjuvant treatment for locally advanced rectal cancer.  METHODS: 62 patients who met the inclusion criteria were randomly assigned to mFOLFOX6 group (control group) and mFOLFOX6 combined with endostatin group (experiment group). The control group received oxaliplatin 85 mg/m2 and leucovorin 200 mg/m2 (i.v. drip) for 2 h on day 1,5-fluorouracil 400 mg/m2 (i.v. push), 5-fluorouracil 2.6 g/m2 (continuous i.v. pump) right after leucovorin for 46 h every two weeks. The experiment group received daily endostatin 7.5 mg·m-2·d-1 (continuous i.v. pump) for 7 d, repeatedly every two weeks on the basis of mFOLFOX6. All patients received 4 to 6 cycles of treatment before surgery. RESULTS:62 patients received a total of 310 cycles of treatment with ratable clinical efficacy. The total response rate of experimental group was 62.5%, which was significant higher than 36.6% of the control group (P<0.05).The pathological complete remission rate of experimental group was 28.1%, which was significant higher than 6.7% of the control group (P < 0.05). The anus preservation rate of experimental group was 81.3%, which was significant higher than 56.7% of the control group (P<0.05).Two groups presented with minor toxic reactions (major grade I and II) and low-rate complications, no significant difference perceived (P>0.05). CONCLUSION: Endostatin combined with mFOLOFX6 regimen as neoadjuvant treatment for locally advanced rectal cancer can improve the response rate, pathologic complete response rate and anal preservation rate while maintain minor adverse reactions and complications, which is referential for clinical application.

Key words: endostatin, rectal cancer, neoadjuvant therapy, pathologic complete response rate, efficacy, toxicity

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