伊立替康联合卡培他滨治疗晚期结直肠癌的临床观察

Clinical observation on irinotecan and capecitabine in the treatment of advanced or mestastatic colorectal cancer

目的观察伊立替康联合卡培他滨治疗晚期结直肠癌的疗效和安全性。方法回顾性分析62例复发或转移性结直肠癌患者，接受伊立替康联合卡培他滨治疗：伊立替康125mg／m^2 d1、d8、d15静脉滴注90min；卡培他滨（希罗达）2500mg/m^2，分早晚2次，第1—14天，每28天重复。治疗至少2个周期，按照WHO标准进行疗效和不良反应评价，并观察至疾病进展时间及总生存期。结果62例患者中，可评价疗效的有59例。其中一线治疗28例，RR42．8％，DCR71．4％，TTP 8．6个月，MST18．8个月；二线治疗31例，RR32．3％，DCR61．2％，TTP 7．2个月，MST13．2个月。不良反应主要为恶心与呕吐、迟发性腹泻、粒细胞减少，多为Ⅰ-Ⅱ度，且一线和二线治疗的不良反应无统计学差异。结论伊立替康联合卡培他滨治疗晚期结直肠癌疗效高，不良反应可耐受，值得扩大样本进一步观察。

Objective To evaluate the efficacy and safety of irinotecan （ CPT - 11 ） combined capecitabine for patients with advanced or metastatic colorectal cancer. Methods Sixty - two patients with histologically proven advanced colorectal cancer received irinotecan 125 mg/m^2 on day 1,8,15 and capecitabine 2 500 mg/（ m^2·d）as an intermitent regimen on day 1 to 14. The regimen was repeated every 4 weeks and efficacy and toxicity were evaluated after 2 cycles. The efficacy and safety were assessed on the basis of WHO evaluation standard of objective therapeutic effect for solid tumor. Results Fifty - nine patients were assessable for responses,including twenty - eight patients received the regimen as the first line chemotherapy and thirty - one patients as the second line chemotherapy. RR was 42.8% ,DCR was 71.4% ,TIP were 8.6 months and MST were 18.8 months in the first line chemotherapy. RR was 32.3% ,DCR was 61.2% ,TIP were 7.2 months and MST were 13.2 months in the second line chemotherapy. Dose limiting toxicity was delayed diarrhea and neutropenia. Most of them were Ⅰ/ Ⅱ degree and tolerable. There was no death during the treatment. Conclusion The combination chemotherapy of irinotecan with capecitabine is an active and tolerable regimen for advanced colorectal cancer.