伊立替康联合氟尿嘧啶、亚叶酸钙治疗晚期大肠癌

Irinotecan plus Fluorouracil/Leucovorin in the Treatment of Advanced Colorectal Cancer

目的观察伊立替康联合氟尿嘧啶、亚叶酸钙治疗晚期大肠癌的疗效及毒副反应。方法对32例晚期大肠癌患者采用FOLFIRI双周方案治疗,伊立替康180mg/m2,静脉滴注90min,d1,亚叶酸钙400mg/m2,静脉滴注d1,5-氟尿嘧啶400mg/m2静脉推注d1,亚叶酸钙后,5-氟尿嘧啶2400mg/m2通过艾克孚泵持续静脉输注48h,于亚叶酸钙和5-氟尿嘧啶推注完后开始用药,14d为1个周期,2个周期评定疗效。结果全组32例完全缓解(CR)1例,部分缓解(PR)8例,病情稳定(SD)15例,病情进展(PD)8例,总有效率28.1%,疾病控制率75%。不良反应主要是迟发性腹泻,中性粒细胞下降,胆碱能综合征及恶心、呕吐等。结论伊立替康联合氟尿嘧啶、亚叶酸钙治疗晚期结直肠癌疗效肯定,毒副反应能耐受,明显提高患者生活质量,值得临床推广应用。

Objective To evaluate the effects and toxicities of the combination of Irinotecan plus 5-fluorouracil,leucovorinin in the treatment of patients with advanced colorectal cancer.Methods 32 patients with advanced colorectal cancer treated with Irinotecan plus fuorouracil/leucovorin（FOLFIRI）,Irinotecan 180mg/m2,ivgtt,90mins,d1;5-fluorouracil 400mg/m2 bolus d1,leucovorin 400mg/m2,ivgtt,d1,followed by 2400mg/m2 civ for 48 hours with Accufuser silicone balloon infuser.Medication begins at the end of LV and 5-Fu intravenous infusion finished.14 days per cycle,treat 2 cycles evaluated.Results 32 patients with complete remission（CR） 1 cases,Partial remission（PR） 8 cases,stable disease（SD） 15 patients,and disease progression（PD） 8 patients,the total effective rate 28.1%,disease control rate of 75%.Adverse events were delayed diarrhea,decreased neutrophils,cholinergic syndrome,nausea and vomiting etc.Conclusion Irinotecan combined with 5-fluorouracil and leucovorinin is effective in the treatment of advanced colorectal cancer,toxicity can be tolerated,significantly improve the patients quality of life,is worthy of clinical application.