| ObjectiveTo analyze whether oxaliplatin-based chemotherapy can benefit from colorectal cancer patients who had relapsed and metastasis after adjuvant chemotherapy with oxaliplatin,and compare the efficacy and safety of oxaliplatin and irinotecan in patients with colorectal cancer who had relapsed and metastasized after adjuvant chemotherapy with oxaliplatin.Methods1.Collected the clinical and pathological data of 18 patients with colorectal ca ncer who were treated with oxaliplatin in the first-line chemotherapy after oxaliplati n-based adjuvant chemotherapy from January 2010 to April 2018,and observed the efficacy,adverse reactions,and progression-free survival.2.Analyzed the clinical and pathological data of patients with colorectal cancer who were relapsed and metastatically treated with oxaliplatin-based adjuvant chemo therapy from January 2010 to April 2018 in our hospital.There were 47 patients in the oxaliplatin group and 102 patients in the irinotecan group.There were no stati stically significant differences in age,gender,tumor location between the two group s.According to the first-line application of chemotherapy drugs,the efficacy,advers e effects,and progression-free survival of first-line chemotherapy were compared bet ween the oxaliplatin group and the irinotecan group.Results1.Seventeen of the 18 patients were evaluated for efficacy,including 3 PR,12 SD,and 2 PD.The total effective rate was 17.7%.the disease control rate was 88.2%,and the median PFS was 5.5 months(1.67 months-18.43 months).1 case was discontinued due to allergies,1 case was discontinued due to intestinal obstruction,the incidence of ?-?malignant vomiting was 55.6%,the incidence of grade ? usea and vomiting was 5.6%,and the incidence of ?-? degree myelosuppression was 50%.The incidence of neurotoxicity was 5.6%,and the incidence of ?-degree liver injury was 5.6%.2.The effective rate of oxaliplatin group was 32.6%,the disease control rate was 89.1%,the median PFS was 8.3 months(1.2-59.57 months);the effective rate of irinotecan group was 35.6%,the disease control rate was 92%,and the median PFS was 8.53 months(1.67-52.77 months),there was no significant difference between the two groups(P>0.05).The incidence of alopecia in the irinotecan group was significantly higher than that in the oxaliplatin group,which was 11.8%vs 0%(P<0.05).In multivariate analysis,the degree of tumor differentiation and whether secondary surgery was an independent factor affecting PFS.In the subgroup analysis,the effective rates of the chemotherapy group and the combined targeted therapy group were 16.7%and 50%,respectively,in the oxaliplatin group.The effective rates of the chemotherapy group and the combined targeted therapy group in the irinotecan group were 19.5%and 46.7%(P<0.05).The median PFS in the oxaliplatin subgroup was 6.73 months and 8.6 months in the chemotherapy alone group and the combined targeted therapy group,respectively.The median PFS in the irinotecan group and the combined therapy group was 7.73 months and 8.6 months(P>0.05).ConclusionsThrough retrospective analysis,found that patients with advanced colorectal cancer who progressed after adjuvant chemotherapy with oxaliplatin-based chemotherapy were still effective in the first-line chemotherapy of oxaliplatin alone,but the efficacy was very low.In the first-line comprehensive treatment,there was no significant difference in efficiency and PFS compared with irinotecan,and it was relatively mild in terms of adverse reactions.In multivariate analysis,the degree of tumor differentiation and whether secondary surgery was an independent factor affecting PFS.In the subgroup analysis,chemotherapy combined with targeted therapy was significantly better than chemotherapy alone in the effective rate,while in the PFS,the chemotherapy combined with the targeting group was longer than the chemotherapy alone group,but the difference was not statistically significant. |
PDF Full Text Request