伊立替康联合氟尿嘧啶二线治疗晚期结直肠癌观察

Clinical Trials of Treating Advanced Colorectal Cancer with Irinotecan Plus 5-Fu

目的:观察伊立替康(CPT-11)联合氟尿嘧啶治疗一线化疗失败的晚期结直肠癌的疗效。方法:61例晚期结直肠癌患者,均为经奥沙利铂、氟尿嘧啶、亚叶酸钙等药物一线化疗失败者,行伊立替康联合氟尿嘧啶方案治疗,第1天伊立替康180 mg/m2静脉滴注90 min,第1天、第2天亚叶酸钙200 mg/m2静脉滴注,第1天、第2天氟尿嘧啶400 mg/m2静脉推注以及600 mg/m2持续滴注22 h,14 d为1个周期3,个周期评价疗效。结果:完全缓解(CR)0例,部分缓解(PR)13例,稳定(SD)23例,进展(PD)25例,总缓解率(RR)21.31%,疾病控制率59.02%,中位肿瘤进展时间(TTP)6.9个月,中位生存期11.5个月。主要毒副反应为中性粒细胞减少和迟发性腹泻,毒副反应能耐受,无化疗相关死亡。结论:伊立替康联合氟尿嘧啶二线治疗晚期结直肠癌疗效满意,耐受性好,值得临床推广。

Objective:To observe the efficacy of irinotecan(CPT-11) plus 5-Fu after first-line chemotherapy failure in patients with advanced colorectal cancer.Methods:61 patients with advanced colorectal cancer whose disease had progressed after treatment with first-line oxaliplatin and 5-Fu/LV chemotherapeutics were treated with irinotecan(CPT-11) plus 5-Fu:CPT-11 180 mg /m2 d1,dripping into vein in 90 minutes;LV 200 mg/m2 d1-d2,dripping into vein;5-Fu 400 mg/m2 d1-d2 and 600 mg/m2 d1-d2 continue dripping into vein in 22 hours.14 days was one cycle.The effect was evaluated after three cycles.Results:0 cases had complete response,13 cases had partial response,23 cases had stable disease and 25 cases with progressive disease.The response rate of the whole group was 21.31%.Median time to progression was 6.9 months.Median overall survival time was 11.5 months.Side reaction were neutropenia and delayed diarrhea.There was no death during the treatment.Conclusion:Irinotecan plus 5-Fu are efficacious and tolerable for treating patients with advanced colorectal cancer after first-line chemotherapy failure.