II、III期结肠癌患者辅助化疗XELOX方案、FOLFOX方案的临床疗效、不良反应及生活质量对比摘要:目的比?八辅助化疗XELOX方案、FOLFOX方案对II、III期结肠癌患者的临床疗效、不良反应及生活质量的差异。方法收集2009年1月〜2012年1月解放军第二五四医院普通外科收治的行根治性手术切除的171例结肠癌患者的临床资料,按数字随机分为两组,90例患者术后接受XELOX化疗方案,81例接受FOLFOX化疗方案。比较两组患者的无病生存期、5年生存率、不良反应发生及生存质量的差异。结果XELOX组34例(37.78%)出现病情进展,FOLFOX组28例(34.57%)出现病情进展。XELOX组、FOLFOX组的3年无病生存率对比,差异无统计学意义(P>0.05)。XELOX组死亡21例(23.33%)。FOLFOX组死亡19例(23.46%)。Log-rank检验结果显示,两组患者5年生存率对比,差异无统计学意义(P>0.05)。两组患者恶性呕吐、高胆红血症的不良反应发生率,差异无统计学意义(P>0.05)。神经毒性、腹泻、白细胞减少、粒细胞减少、血小板减少、口腔黏膜炎的发生率,FOLFOX组高于XELOX组,差异有统计学意义(P0.05)o结论对II、III期结肠癌患者而言,XELOX方案与FOLFOX方案在提高术后无病生存期、5年生存率及生活质量方面无明显差异。但XELOX方案不良反应更少,患者的依从性与耐受性更好。关键词:结肠癌;卡培他滨;奥沙利铂;氟尿嘧啶中图分类号:R735.3文献标识码:ADOI:10.3969/j.issn.1006-1959.2018.13.020文章编号:1006-1959(2018)13-0068-05Abstract:ObjectiveTocomparetheclinicalefficacy,adversereactionsandqualityoflifeofpatientswithstageIIandIIIcoloncancerbyXELOXandFOLFOX.MethodsTheclinicaldataof171patientswithcoloncancerwhounderwentradicalsurgeryforgeneralsurgeryinthe254thHospitalofChinesePeople'sLiberationArmyfromJanuary2009toJanuary2012werecollected.Theywererandomlydividedintotwogroupsaccordingtothenumber.90patientsreceivedXELOXchemotherapyafteroperationand81patientsreceivedFOLFOXchemotherapy.Thedisease-freesurvival,5-yearsurvivalrate,adversereactionoccurrenceandqualityoflifewerecomparedbetweenthetwogroups.ResultsIntheXELOXgroup,34patient(s37.78%)developeddiseaseprogression,and28patients(34.57%)intheFOLFOXgroupdevelopeddiseaseprogression.Therewasnosignificantdifferenceinthe3-yeardisease-freesurvivalratebetweentheXELOXgroupandtheFOLFOXgroup(P>0.05).21patients(23.33%)diedintheXELOXgroup.19patients(23.46%)diedintheFOLFOXgroup.Log-ranktestresultsshowedthattherewasnosignificantdifferenceinthe5-yearsurvivalratebetweenthetwogroups(P>0.05).Therewasnosignificantdifferenceintheincidenceofadversereactionsbetweenmalignantvomitingandhyperbilirubinemiabetweenthetwogroups(P>0.05).Theincidenceofneurotoxicity,diarrhea,leukopenia,neutropenia,thrombocytopenia,andoralmucositiswashigherintheFOLFOXgroupthanintheXELOXgroup,thedifferencewasstatisticallysignificant(P0.05).ConclusionForpatientswithstageIIandIIIcoloncancer,thereisnosignificantdifferencebetweentheXELOXregimenandtheFOLFOXregimeninimprovingpostoperativedisease-freesurvival,5-yearsurvival,andqualityoflife.However,theXELOXregimenhasfewersideeffectsandbetterpatientcomplianceandtolerance.Keywords:Coloncancer;Capecitabine;Oxaliplatin;Fluorouracil结肠癌(coloncancer)是消化道常见的恶性肿瘤,随着我国经济社会的发展和生活水平的提高,人们的食物谱发生了很大改变,高油脂、高蛋白、低纤维素的膳食结构也在一定程度上促进了我国结肠癌发病率的增高[1,2]。目前,外科手术仍然是结肠癌患者获得根治的基础[3],但手术不能彻底清除组织或血液中存在的微小转移灶,因此,有效的术后化疗是结肠癌获得长期生存的必要条件[4]。XELOX方案与FOLFOX方案是目前临床较为成熟的两种化疗方案,已有...