FOLFIRI方案一线治疗晚期大肠癌的临床观察

Effects of FOLFIRI regimen in first-line treatment for metastatic colorectal cancer

目的:观察伊立替康(IRI,CPT-11)联合氟尿嘧啶(5-FU)、甲酰四氢叶酸(CF)一线治疗晚期大肠癌的疗效及毒副作用。方法:对采用FOLFIRI方案治疗的晚期结直肠癌患者32例进行回顾性分析,每例患者至少接受3个周期化疗,中位化疗6个周期。用法:CPT-11 180mg/m2,静脉滴注90min,第1天;CF200mg/m2,静脉滴注2h,第1、2天;5-FU 400mg/m2,继CF后静脉推注,然后600 mg/m2,持续静脉滴注22小时,第1、2天,14天重复。每3-4个周期后按照RECIST实体瘤近期客观疗效评定标准进行疗效评价。观察疗效和不良反应。结果:完全缓解(CR)0例;部分缓解(PR)13例,占40.6%;稳定(SD)10例,占31.3%;疾病进展(PD)9例,占28.1%;客观有效率(CR+PR)为40.6%;临床获益率(CR+PR+SD)为71.9%,中位疾病进展时间(TTP)5.2个月;中位生存期(MST)18.1个月。不良反应主要为骨髓抑制、消化道反应。结论:FOLFIRI方案一线治疗晚期结直肠癌,疗效较好,毒副反应可耐受,值得临床上广泛应用。

Objective：To observe the efficacy and safety of FOLFIRI regimen in first-line treatment of patients with metastatic colorectal cancer.Methods：Thirty-two patients with metastatic colorectal cancer treated with FOLFIRI regimen were reviewed and analyzed.All patients received at least 3 cycles of chemotherapy.The regimen included irinotecon（CPT-11）180 mg/m2 d1,iv dripping in 90 minutes;leucovorin（CF） 200 mg/m2 iv infusion over 2 hours on day 1and day 2;fluorouracil 400 mg/m2 iv bolus,then 600 mg/m2 iv infusion over 22 hours on d1 and d2.Treatment was repeated every 14 days.The patients were assessed on the basis of Response Evaluation Criteria in Solid Tumors（RECIST） after 3-4 cycles.Results：Thirty-two patients were assessable for the efficacy and safety.Of them,0 had complete response;13 had partial response;10 had stable disease and 9 had progression disease.The over-all response rate was 40.6%（13/32）;clinical tumor control rate was 71.9%（23/32）.Median time to progress（TTP） was 5.2 months and median survival time（MST） was 18.1 months.The main toxic reactions were leukopenia,nausea and vomiting.Conclusion：FOLFIRI regimen is effective and well tolerable in the first-line treatment for metastatic colorectal cancer,and is worth of use and wide spread.