恩度联合FOLFIRI方案治疗结直肠癌肝转移的临床研究

Clinical observation of rh-endostatin combined with FOLFIRI regimen in colorectal cancer with hepatic metastasis

目的分析恩度(重组人血管内皮抑素)联合FOLFIRI方案治疗结直肠癌肝转移患者的近期疗效与不良反应。方法搜集2009年2月至2012年5月24例结直肠癌肝转移患者的临床资料,应用恩度与FOLFIRI化疗方案联合治疗。其中,恩度15mg静脉点滴,d1～10,每2周为1周期。应用FOLFIRI化疗方案:伊立替康180mg/m2静脉点滴,d1;亚叶酸钙400mg/m2静脉点滴,d1;氟尿嘧啶400mg/m2静脉推注,d1,2400mg/m2持续静脉微量泵泵入46h,每2周为1周期。每3～4个周期评价疗效,每周期随时评价毒副反应,恩度应用直至病情进展或患者拒绝继续应用。结果 24例患者中,CR 2例,PR 9例,SD 7例,PD6例,有效率为45.83%,疾病控制率为75.00%;全组共24例患者均完成随访,未发生较重的心血管系统毒副反应,主要为1～2度的血液学毒性和胃肠道反应,如恶心、呕吐和迟发性腹泻,经对症治疗可恢复正常。结论在FOLFIRI化疗方案的基础上联合恩度治疗结直肠癌肝转移的疗效比较确切,用药安全性良好,值得临床借鉴。

Objective To Short-term efficacy and adverse reactions（endostar）combined with FOLFIRI regimen in colorectal cancer with hepatic metastasis. Methods Twenty-four patients with hepatic metastasis of colorectal cancer were treated with endostar and FOLFIRI regimen from February 2009 to May 2012. Endostar 15rag solved in 500ml normal saline was slowly intravenously dropped from day 1 to day 10 biweekly. FOLFIRI regimen： irinotecan 180mg/m^2 iv, dl ; leucovorin 400mg/m^2 introvenous infusion to match duration of irinotecan infusion, dl ;fluorouracil 400mg/m^2 iv bolus dl ,and then 2400mg/m^2 for 46 h continuously infusion. Every 2 weeks was a cycle. The adverse reactions was evaluated after 1 cycle while the efficacy was evaluated after 3-4 cycles. Results All the cases were evaluated for safety and 24 cases for efficacy with 2 of CR,9 of PR,7 of SD and 6 of PD. The response rate was 45.83% and disease control rate was 75.0%. The adverse effects were mainly in grade 1-2, including hematological toxieities,nausea and vomiting and tardive diarrhea. There was no serious event in cardiovascular system. Conclusion The efficacy and tolerability of endostar plus FOLFIRI regimen in hepatic metastasis of colorectal cancer was good with tolerable adverse effect.