羟基喜树碱联合卡培他滨治疗FOLFOX化疗失败晚期大肠癌的临床观察

Clinical study of hydroxycamptothecin combined with capecitabine for treatment of recurrent colorectal cancer with FOLFOX failure

目的观察羟基喜树碱（HCPT）联合卡培他滨（Cap）治疗FOLFOX化疗失败后晚期大肠癌的近期疗效及毒性反应。方法36例FOLFOX治疗失败的晚期大肠癌患者采用HCPT6mg／m^2，静脉滴注，d1～5；卡培他滨1000mg／m^2，口服，2次／d，第1～14天，3周为一周期，至少2周期后评价疗效。按WHO标准评价近期疗效和毒副反应。结果可评价疗效者36例，CR1例，PR12例，有效率为36．1％。中位至疾病进展时间（mTFP）6．7个月，中位生存时间（MST）15．8个月，1年生存率41．7％。毒副反应主要是骨髓抑制、手足综合征、胃肠道反应，全组无治疗相关性死亡。结论羟基喜树碱联合卡培他滨治疗FOLFOX失败晚期大肠癌有较好的疗效，毒副反应可以耐受，值得进一步观察。

Objective To evaluate the efficacy and toxicity of hydroxycamptothecin （HCPT） in combination with capecitabine （Cap） as second-line treatment in recurrent colorectal cancer patients with FOLFOX failure. Methods Thirty-six patients with advanced colorectal cancer after failure of FOLFOX pretreatment were treated with HCPT 6mg/m^2, ivgtt, d1-5 ; Cap 1000 mg/ m^2, po, bid, d1-14 ; every 3 weeks as one cycle. The efficacy was evaluated after two cycles. The efficacy and toxicity were evaluated according to WHO standard. Results Thirty-six patients could be evaluated for clinical response. Complete response in 1 patient and partial response in 12 patients were observed with an overall response rate of 36. 1%. Median time to progression （mTrP） was 6. 7 months and median survival time （MST） was 15. 8 months. The 1-year survival rate was 41.7%. The most common toxic reactions were bone marrow suppression, hand-foot syndrome, nausea and vomiting. There was no treatment-related death. Conclusion HCPT combined with Cap is an effective and tolerable alternative treatment for the recurrent colorectal cancer patients with FOLFOX failure and shows promising activity.