Comparing Of Syndrome Classification In Traditional Chinese Medicine Of Common Gastrointestinal Side Effects From Chemotherapy Regimens Including Fluorouracil And Raltitrexed For Metastatic Colorectal Cancer

Objective:Analysis and comparisons the common gastrointestinal side effects from chemotherapy regimens including fluorouracil (5-Fu) and raltitrexed of treating metastatic colorectal cancer and take syndrome classification in traditional Chinese medicine. And it can take the reference value for metastatic colorectal cancer patients to choose chemotherapy regimens.Methods:Collected109cases of metastatic colorectal cancer patients who conform to the group from the abdominal tumor medical of our hospital from Jan.2013to Mar.2014.51cases were treated with chemotherapy regimens including raltitrexed, and the other58cases with5-Fu. Some of these patients were treated with chemotherapy combined molecular targeted drug therapy(bevacizumab, cetuximab). The doses of the drugs were as follows:raltitrexed2.0mg/m2ivgtt15min, d2;5-Fu2.4/m2civ48h; irinotecan180mg/m2ivgtt Ih,d2;and oxaliplatin85mg/m2ivgtt2h, d2; bevacizumab5mg/kg ivgtt6h, dl; cetuximab400mg/m2ivgtt6h, dl,250mg/m2ivgtt4h, d8, repetition weekly;2weeks was a cycle for each regimen. Each patient accepted at least2cycles chemotherapy. And until disease progression or appear toxicity which patients cannot tolerate. Using NCI CTC4.0to evaluate gastrointestinal side effects from chemotherapy to0-4grades. And take syndrome classification in traditional Chinese medicine. The statistical analysis is to using the SPSS16.0software.Results:There were109cases of metastatic colorectal cancer patients at the inception of the study. Among them, divided into two groups:51cases into the raltitrexed and58cases into the5-Fu. Combined with molecular targeted drug,22cases into the raltitrexed and23cases into the5-Fu. In the two drugs combination chemotherapy,21cases into the raltitrexed and29cases into the5-Fu. For the traditional Chinese medicine, only the occurrence rate of diarrhea (Shireshangzhong) was variant (P=0.012). And only the occurrence rate of diarrhea was variant (P=0.000). Subgroup analysis shows:Combined with molecular targeted drug, it was also the occurrence rate of diarrhea was variant (P=0.028). The two drugs combined analysis result show that the occurrence rate of diarrhea was variant (P=0.020). Conclusions:1.The gastrointestinal side effects of raltitrexed is lighter than5-Fu. They are both cytotoxic drugs which act on the thymidylic acid synthase(TS) and interfere with cell metabolism. The common gastrointestinal side effects are nausea, vomiting, abdominal pain, diarrhea, constipation, etc.2. The occurrence rate of diarrhea (Shireshangzhong) was obviously variant, the raltitrexed group was lighter than the5-Fu. So, the raltitrexed is better for the shireyongzhi.3. Combined chemotherapy contains raltitrexed or5-Fu which also Combined with molecular targeted drug (such as bevacizumab, cetuximab) be used for metastatic colorectal cancer patients, and it did not increase the gastrointestinal side effects. This strategy is highly safe.4. The strategy of raltitrexed combined with oxaliplatin or irinotecan treats metastatic colorectal cancer is highly safe.