伊立替康联合奥沙利铂三线治疗晚期胃癌的疗效分析

Efficiency of combined irinotecan and oxaliplation third-line chemotherapy in advanced gastric cancer patients

目的 观察伊立替康（CPT-11） 联合奥沙利铂（LOHP） 三线治疗晚期胃癌的疗效及不良反应。 方法 回顾性分析2007年7 月- 2012 年7 月在我院接受伊立替康联合奥沙利铂三线治疗的31 例晚期胃癌患者的临床资料。按伊立替康180 mg/m 2 静脉滴注2 h，奥沙利铂85 mg/m 2 静脉滴注2 h，21 d 为1 个周期。每1 周期后根据美国国家癌症研究所不良事件常用术语评定标准（CTCAE）3.0 版进行不良反应分级，每2 周期后按实体瘤客观疗效评价标准（RECIST）1.1 版评价疗效，统计临床有效率和不良反应发生率，并采用Kaplan-Meier 进行生存分析。 结果 31 例中完全缓解（CR）1 例（3.2%），部分缓解（PR）6例（19.4%），稳定（SD）19 例（61.3%），进展（PD）5 例（16.1%），有效率（CR＋PR）22.6%，疾病控制率（CR＋PR＋SD）83.9%。无进展生存期（progression-free survival，PFS）5.0 个月（95% CI ：3.2 ～ 6.8），中位总生存时间（overall survival，OS）7.8 个月（95% CI ：6.7 ～8.9）。严重不良反应包括粒细胞减少3 级以上5 例（16.1%），白细胞减少3 级以上6 例（19.4%），血小板减少3 级以上3 例（9.7%），贫血3 级以上2 例（6.5%），腹泻3 级以上2 例（6.5%）。无治疗相关性死亡。 结论 伊立替康联合奥沙利铂三线治疗晚期胃癌的近期疗效确切，不良反应可耐受。

Objective To observe the efficiency of combined irinotecan （CPT-11） and oxaliplation （LOHP） third-line chemotherapy in advanced gastric cancer patients and its adverse reactions. Methods Clinical data about 31 advanced gastric cancer patients who received combined CPT-11 and LOHP third-line chemotherapy in our hospital from July 2007 to July 2012 were retrospectively analyzed. The patients were treated with intravenous CPT-11 （180 mg/m 2 ） and LOHP （85 mg/m 2 ）, respectively, with 21 days as a cycle. Their adverse reactions were assessed after each cycle according to the NCI-CTCAE （version 3.0） and the efficiency of the combined therapy was assessed after 2 cycles according to the RECIST （version 1.1）. The effective rate of the combined therapy and the incidence of adverse reactions were calculated. The survival rate of patients was analyzed using the Kaplan–Meier product limit method. Results Of 31 patients, 1 （3.2%） was completely remitted, 6 （19.4%） were partially remitted, 19 （61.3%） became stable, and 5 （16.1%） had progression with an overall response rate （CR＋PR） of 22.6% and a disease control rate （CR＋PR＋SD） of 83.9%. The progression-free survival （PFS） time was 5.0 months （95% CI： 3.2-6.8） and the median overall survival （OS） time was 7.8 months （95% CI： 6.7-8.9）. Severe adverse reactions included neutropenia in 5 patients （16.1%）, leucopenia in 6 patients （19.4%）, thrombocytopenia in 3 patients （9.7%）, anaemia in 2 patients （6.5%） and diarrhea in 2 patients （6.5%）. No chemotherapy-related death occurred. Conclusion The short-term efficiency of combined CPT-11 and LOHP third-line chemotherapy is good and its adverse reactions are tolerable in advanced gastric cancer patients.