mFOLFIRI方案一线治疗晚期大肠癌的临床观察

First-line Treatment of Advanced Colorectal Cancer with mFOLFIRI Program

目的观察改良的氟尿嘧啶/亚叶酸钙(5-FU/CF)联合伊立替康方案(mFOLFIRI方案)一线治疗晚期大肠癌的疗效及不良反应。方法对48例经病理证实的晚期大肠癌患者采用伊立替康180 mg.m-2,静脉滴注2 h,第1天;亚叶酸钙400 mg.m-2,静脉滴注2 h,第1天,5-FU 2.6 g.m-2持续电脑微量泵泵入46 h,同时给予止吐、抑酸等对症治疗,2周为1个周期,3个周期后评价疗效。结果 48例患者均获随访,中位随访时间2年。其中完全缓解(CR)2例,部分缓解(PR)16例,疾病稳定(SD)14例,疾病进展(PD)16例,有效率(RR)为37.5%,疾病控制率(CBR)为66.7%。中位生存期(MST)16.8个月,中位疾病进展时间(mTTP)7.1个月。不良反应程度轻,多为Ⅰ-Ⅱ度,主要有腹泻、骨髓抑制、恶心呕吐、乏力等。结论 mFOLFIRI方案治疗晚期大肠癌患者疗效好,不良反应小。

Objective To observe the effect and toxicity of first-line treatment of advanced colorectal cancer with mFOLFIRI program（5-fluorouracil/leucovorin combined with irinotecan）.Methods Forty-eight patients with pathologically confirmed advanced colorectal cancer were treated with intravenous infusion of irinotecan（180 mg·m^-2） and leucovorin（400 mg·m^-2） for 2 hours and then were given continuous 5-FU infusion（2.6 g·m^-2） for 46 hours on day 1 every 2 weeks.Meanwhile,these patients received antiemetic and acid suppression treatment.Patients were evaluated every 3 cycles.Results Patients were followed-up for an average of 2 years.Among the 48 patients,complete remission（CR） occurred in 2,partial remission（PR）in 16,stable disease（SD） in 14,and progressive disease（PD） in 16.The effective rate and disease control rate were 37.5% and 66.7%,respectively.The median survival time and median time to progression were 16.8 months and 7.1 months,respectively.The main side effects were diarrhea,myelosuppression,nausea/vomiting and fatigue,and most of them were grade Ⅰ-Ⅱ.Conclusion mFOLFIRI treatment of advanced colorectal cancer is effective for advanced colorectal cancer with mild side effects.