晚期结直肠癌内科治疗进展

Advances in medical treatment of metastatic colorectal cancer

晚期转移性结直肠癌的5年生存率低于10%。5-FU/LV方案治疗的中位生存期大约12个月。最近化疗方案的更新延长了患者的中位生存期。研究发现奥沙利铂、伊立替康联合5-FU/LV或者卡培他滨等化疗方案使中位生存期延长到20个月。奥沙利铂,伊立替康联合5-FU/LV比传统的单药5-FU/LV使生活质量改善时间延长。目前转移性结直肠癌标准的一线治疗方案为FOLFOX和FOLFIR I。正在进行的研究关注新的分子靶向药物(molecu lar targeted therapy)联合化疗治疗转移性结直肠癌,且部分试验取得了较好的疗效。本文将对5-FU、新一代化疗药物以及分子靶向药物在转移性结肠癌治疗的演进及新进展作一综述。

The overall 5-year survival rate for patients with metastatic colorectal cancer （CRC） is less than 10%. Median survival with 5-fluorouracil （5-FU）/leucovorin （LV） therapy is approximately 12 months. Recent additions to the chemotherapy armamentarium for this disease have begun to prolong median survival times. In trials in which patients are exposed to all three approved chemotherapy agents, oxaliplatin, irinotecan, and 5-FU/LV, or capeeitabine during the course of their disease, median survival has reached 20 months. The addition of oxaliplatin and irinotecan to 5-FU/LV regimens has also led to the maintenance of quality of life for longer intervals than were traditionally observed with 5-FU/LV alone. Current standard first-line regimens for metastatic CRC are FOLFOX （ infusional 5-FU/LV with oxaliplatin） and FOL FIRI （ infusional 5-FU/LV with irinotecan）. Ongoing investigations will identify a place for molecular targeted combination chemotherapy on metastatic colorectal cancer （CRC） and some trials achieved better efficiency. In this review, we discuss the current advances in combined management of metastatic colorectal cancer of 5-Fu, chemotherapy , Molecular targeted therapy.