恩度和沙利度胺联合化疗治疗转移性结直肠癌的临床观察

发布时间：2018-01-21 16:41

本文关键词： 转移性结直肠癌靶向治疗抗血管生成治疗恩度沙利度胺　出处：《北京协和医学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的：观察重组人血管内皮抑制素(Endostar,恩度)和沙利度胺(Thalidomide)与细胞毒药物联合治疗晚期结直肠癌的疗效和安全性。方法：自2006年1月至2013年1月,51例转移性结直肠癌患者于中国医学科学院肿瘤医院接受恩度、沙利度胺联合细胞毒药物治疗,排除2例未评价疗效的患者,2例失访患者,共47例患者纳入研究。分别按照实体瘤的疗效评价标准(RECIST) 1.0和国立癌症研究所毒性判定标准(NCI-CTC) 4.0评价疗效和毒性。具体给药方案为：恩度15mg/d,加入生理盐水500ml静脉滴注,化疗第1天开始,连用10天；沙利度胺150mg或200mg,每晚睡前顿服,化疗第1天开始,连用10天。与恩度和沙利度胺联用的化疗方案均为双周方案,包括：奥沙利铂+氟尿嘧啶类药物(18例),奥沙利铂+雷替曲塞(1例),伊立替康+氟尿嘧啶类药物(26例),伊立替康+雷替曲塞(2例)。结果：一线、二线、三线及三线以上接受含恩度和沙利度胺联合化疗方案的患者中位生存期(mOS)分别为：26.1个月(95% CI：21.9～30.2个月)、15.3个月(95% CI：9.5～21.0个月)、7.5个月(95% CI：4.2-10.7个月)；中位无进展生存时间(mPFS)分别为：11.1个月(95%CI：8.6-13.7个月)、7.9个月(95%CI：4.7-11.2个月)、4.2个月(95% CI：1.5-7.0个月)；有效率(RR)分别为：63.1%、37.5%、16.7%：疾病控制率(DCR)分别为：84.2%、68.7%、66.7%。3/4级不良事件包括中性粒细胞减少(8.5%),血小板减少(6.4%),恶心(4.3%),呕吐(4.3%),便秘(4.3%),疲乏(2.1%),周围神经毒性(2.1%)。结论：恩度、沙利度胺联合细胞毒药物对初治和复治的转移性结直肠癌患者有较好的疗效及安全性。
[Abstract]:Objective: to observe the expression of recombinant human endotheliostatin Endostar. Endol) and thalidomide (Thalidomide) combined with cytotoxic drugs in the treatment of advanced colorectal cancer. Methods: from January 2006 to January 2013. Fifty-one patients with metastatic colorectal cancer were treated with Endor, thalidomide and cytotoxic drugs at the Cancer Hospital of the Chinese Academy of Medical Sciences. A total of 47 patients were included in the study. According to the criteria for evaluating the efficacy of solid tumors (RECIST) 1.0 and the National Cancer Institute (NCI-CTC), respectively. 4. Evaluation of efficacy and toxicity. The specific regimen was as follows: Endol 15 mg / d. Add normal saline 500ml intravenous drip, the first day of chemotherapy, continuous use for 10 days; Thalidomide 150 mg or 200 mg per night before bedtime. The chemotherapy regimen combined with Endor and thalidomide was a biweekly regimen starting on the first day of chemotherapy for 10 days. There were 18 cases of oxaliplatin fluorouracil, 1 case of oxaliplatin retitrexide and 26 cases of Ilitecondolouracil). Results: first line, second line. The median survival time (MSOS) of the patients receiving chemotherapy regimen containing Endor and thalidomide was 26.1 months (95% CI:21.9~30.2 months). 15.3 months, 95% CI:9.5~21.0, 7.5 months, 95% CI:4.2-10.7. The median non-progressive survival time (mPFS) is respectively: 11.1 months and 95% CI: 8.6-13.7 months, 7.9 months, 95 CI: 4.7-11.2 months). 4.2 months, 95% CI:1.5-7.0; The effective rate is: 63.1% and 37.5%, respectively. The disease control rate (DCR) is 68.7%. The adverse events included neutropenia (8.5%), thrombocytopenia (6.4%), nausea (4.33%), vomiting (4.3%) and constipation (4.3%). Conclusion: Endol and thalidomide combined with cytotoxic drugs have better efficacy and safety in patients with primary and recurrent metastatic colorectal cancer.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.34

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