伊立替康二线治疗14例晚期结直肠癌

Irinotecan in 14 cases wtih advanced colorectal cancer as second-line treatment

目的 :研究伊立替康二线治疗晚期结直肠癌的疗效及其不良反应。方法 :14例既往氟尿嘧啶 (5 FU)治疗失败的晚期结直肠癌患者接受单药伊立替康 30 0mg/m2 ,静脉点滴 ,每 3周为一疗程。全部患者以前曾接受过含氟尿嘧啶的辅助化疗 ,2例曾接受过盆腔放疗。结果 :9例患者接受 3疗程化疗 ,5例接受 6疗程化疗。 14例患者中SD 10例 ,PD 4例。常见治疗毒性为乙酰胆碱能综合征 13例 (92 .9% ) ,延迟性腹泻 11例 (78.6 % )和中性粒细胞减少 11例 (78.6 % ) ;Ⅲ度毒性 :恶心呕吐 2例 (14 .3% ) ,延迟性腹泻 2例 (14 .3% )和中性粒细胞减少 /白细胞减少 1例 ;仅 1例患者发生Ⅳ度腹泻。结论

Purpose:To investigate the efficacy and adverse effects of irinotecan, a novel and potent inhibitor of topoisomerase Ⅰ, for second line treatment of advanced colorectal cancer.Methods:14 patients who previously failed with fluorouracil treatment received single drug irinotecan 300 mg/m 2 intravenously every 3 weeks . All patients had received adjuvant therapy containing fluorouracil. Two patients had received pelvic radiotherapy.Results:Nine patients had received three cycles and five patients completed six cycles . Ten cases had stable disease, and four with progressive disease were observed among the 14 patients. The common treatment related adverse events were cholinergic syndrome (92.9%) ,delayed diarrhea (78.6%) and neutropenia (78.6%) . Grade Ⅲ side effects occurred in several patients: two nausea/ vomiting , two delayed diarrhea and one neutropenia / leucytopenia . Only one patient developed grade Ⅳ diarrhea.Conclusions: Irinotecan is an active drug in the treatment of advanced colorectal cancer with acceptable toxicity.