FOLFIRI治疗转移性结直肠癌34例临床观察

Clinical study on combination of irinotecan,fluorouracil with leucovor for 34 cases of metastatic colorectal cancer

目的:观察国产伊立替康联合氟尿嘧啶和四氢叶酸钙组成的FOLFIRI方案治疗晚期结直肠癌的临床疗效及不良反应。方法:有客观病灶的转移性结直肠癌患者共34例。FOLFIRI方案具体用法为:国产伊立替康180mg.m-2静脉滴注,第1天;氟尿嘧啶400mg.m-2静脉滴注,第1,2天;600mg.m-2持续泵化疗22h,第1,2天;四氢叶酸钙注射液200mg.m-2静脉滴注,第1,2天。14d为1个周期,3个周期(6周)评价疗效。结果:部分缓解(PR)8例,稳定(SD)14例,进展(PD)9例,其中一线治疗患者有效率达42.8%,总缓解率25.8%,总稳定率45.2%。中位缓解时间6.7个月,中位稳定时间8个月。常见不良反应为血液学毒性(白细胞下降47.1%,Ⅲ度白细胞下降占5.8%)和腹泻(23.5%)。结论:以国产伊立替康为基础的FOLFI-RI方案治疗晚期结直肠癌有效率高,不良反应可以耐受,可作为晚期结直肠癌的一线或二线化疗方案。

OBJECTIVE To evaluate the clinical efficacy and adverse effects of irinotecan combined with 5-Fu /CF in treatment of advanced colorectal cancer. METHODS 34 patients with advanced colorectal cancer received therapy,2 week regimen： CPT-11 180 mg·m^-2 ivgtt d1,CF 200 mg·m^-2 ivgtt followed by 5-Fu 400 mg·m^-2 ivgtt and 5-Fu 600 mg·m^-2 ivgtt 22 h, d1-2,14 days a cycle. RESULTS 31cases were evaluable for efficacy,partial response were observed in 8 cases, The overall response rate was 25.8% and the stable rate was 45.2%. The median relief time was 6.7 months, The median stable time was 8 months. Dose limiting toxicity （DLT） was delayed diarrhea and neutropenia. CONCLUSION Irinotecan combined with 5 Fu/ CF regimen is an effective and better tolerated alternative treatment in advanced colorectal cancer and yields promising clinical application.