标题：三种方案治疗老年晚期结肠癌患者的疗效及安全性研究

      作者：刘真真 1，张玉洁 2，李亚妮 3    1.西安市人民医院(西安市第四医院)消化内科，陕西 西安 710004；2.空军军医大学第一附属医院消化内科，陕西 西安 710032；3.西安市红会医院消化内科，陕西 西安 710000

      卷次： 2021年32卷3期

      【摘要】 目的 探讨三种方案治疗老年晚期结肠癌患者的疗效及安全性。方法 选择2017年3月至2019年4月空军军医大学第一附属医院收治的90例老年晚期结肠癌患者进行研究。通过随机数表法将患者分为A组、B组和C组各30例，三组患者均给予奥沙利铂治疗，在此基础上A组联合替吉奥治疗，B组联合卡培他滨治疗，C组联合尿嘧啶治疗，三组均以21 d为一个疗程，连续用药两个疗程。比较三组患者的临床疗效，治疗前后的血清癌胚抗原(CEA)、天冬酰胺内肽酶(AEP)、癌胚抗原19-9 (CA19-9)、胸苷激酶1 (TK1)水平，生存率以及不良反应发生情况。结果 治疗后，A组、B组和C组患者的疾病总缓解率分别为73.33%、66.67%、53.33%，三组比较差异无统计学意义(P>0.05)；治疗后，三组患者的血清CEA、AEP、CA19-9、TK1较治疗前明显降低，且A组均明显低于B组，B组明显低于C组，差异均有统计学意义(P<0.05)；1年内A组、B组和C组患者的病死率分别为6.67%、10.00%、16.67%，三组比较差异无统计学意义(P>0.05)；A组、B组和C组患者治疗期间的不良反应总发生率分别为10.00%，20.00%，36.67%，差异有统计学意义(P<0.05)，且A组不良反应总发生率明显低于C组，差异有统计学意义(P<0.05)。结论 奥沙利铂联合替吉奥治疗老年结肠癌晚期能有效改善患者的血清CEA、AEP、CA19-9、TK1水平，减少不良反应，临床治疗效果显著。
      【关键词】 老年；晚期结肠癌；临床疗效；不良反应；生存率
      【中图分类号】 R735.3+5 【文献标识码】 A 【文章编号】 1003—6350（2021）03—0332—04

Efficacy and safety of three regimens in the treatment of elderly patients with advanced colon cancer.
LIUZhen-zhen 1, ZHANG Yu-jie 2, LI Ya-ni 3. 1. Department of Gastroenterology, Xi'an People's Hospital (Xi'an FourthHospital), Xi'an 710004, Shaanxi, CHINA; 2. Department of Gastroenterology, the First Affiliated Hospital of Air ForceMedical University, Xi'an 710032, Shaanxi, CHINA; 3. Department of Gastroenterology, Xi'an Honghui Hospital, Xi'an710000, Shaanxi, CHINA
【Abstract】 Objective To study the efficacy and safety of three regimens in the treatment of elderly patientswith advanced colon cancer. Methods A total of 90 elderly patients with advanced colon cancer admitted to the FirstAffiliated Hospital of Air Force Military Medical University from March 2017 to April 2019 were selected for thestudy. The patients were divided into group A, group B, and group C by random number table method, with 30 patientseach. The three groups were all treated with oxaliplatin, on the basis of which group A combined with tegiotherapy,group B combined with capecitabine treatment, group C was further treated with uracil. The three groups were treatedwith 21 days as a course of treatment, for 2 consecutive courses. The clinical efficacy of the three groups of patients,changes in serum carcinoembryonic antigen (CEA), asparagine endopeptidase (AEP), carcinoembryonic antigen 19-9(CA19-9), thymidine kinase 1 (TK1) levels before and after treatment, survival rate, and occurrence of adverse reac-tions were compared among the three groups. Results After treatment, the total remission rates of group A, group B,and group C were 73.33%, 66.67%, and 53.33%, respectively, with no significant difference between the three groups(P>0.05). There was no significant difference between group A, group B, and group C in 1 year (6.67% vs 10.00% vs16.67%), P>0.05. The total incidence of adverse reactions in group A, group B, and group C were 10.00%, 20.00%,and 36.67% respectively, and the total incidence of adverse reactions in group A was significantly lower than that ingroup C (P<0.05). Conclusion Oxaliplatin combined with tegafur in the treatment of elderly patients with advancedcolon cancer can effectively improve the serum CEA, AEP, CA19-9, TK1 levels, reduce adverse reactions, clinical treat-ment effect is significant.
      【Key words】 Elderly; Advanced colon cancer; Clinical efficacy; Adverse reactions; Survival rate