CPT-11联合5-Fu/FA治疗晚期大肠癌

CPT-11 Combined with 5-Fu/FA in Treatment for Advanced Colorectal Carcinoma

目的研究CPT-11(伊立替康)联合5-Fu(5-氟脲嘧啶)/FA治疗晚期大肠癌的疗效及其不良反应,及拓扑异构酶-1(TopoⅠ)阳性对CPT-11的疗效是否有预测作用。方法28例晚期大肠癌患者接受治疗CPT-11 180 mg/m2,静脉滴注,第1天;FA 200 mg/m2,静脉滴注,第l^2天;5-Fu 400 mg/m2静脉推注,5-Fu 600 mg/m2静脉滴注22 h,第1~2天,每2周重复1次(l个周期)的方案治疗,4个周期后评价疗效。结果在27例可评价疗效的患者中,CR 1例,PR 7例,SD 8例,PD 11例,有效率29.62%。经卡方检验,TopoⅠ阳性组及阴性组有效率、疾病控制率及中位TTP比较,均无显著性差异。Ⅲ~Ⅳ度毒性反应以骨髓毒性及延迟性腹泻为著。结论CPT-11联合5-Fu治疗晚期大肠癌有一定疗效,且毒性可以耐受。TopoⅠ阳性组及阴性组治疗反应相仿。

Objective Researching the effects and side effects by means of the CPT-11 combined with 5-Fu/FA in treatment for advanced coloretal cancer patients, and evaluating if the positive Topo Ⅰ index plays the progonostieating role in treating CPT- 11. Methods 28 patients with advanced colorectal cancer were treated with： CPT-11 180 mg/m^2, ivgtt,90 mins,on 1st day; FA 200 mg/m^2 ivgtt,4 h,on 1st to 2nd day, 5-Fu 400 mg/m^2,Ⅳ, and 5-Fu 600mg/m^2 ely for 22 hrs on 1st to 2nd day, every two weeks as a cycle. Effect evaluated after 4 cycles. Results With general response rate of 29.6 %, there are 1 with CR, 7 with PR, 8 with SD and 11 with PD among total 27 effeets-evaluable patients. No significant defference among response rote, disease-controlable rate and median TTP between negative and positive Topo Ⅰ groups. The incidence of grade Ⅲ～Ⅳ toxicity were delayed diarrhea , neutropenia. Conclusion The definite effects and tolerable toxicity in treating with advanced coloreetal cancer by CPT-11 combined with the 5-Fu. The similar reactions occuring on both negative and positive Topo Ⅰ groups.