伊立替康与替吉奥联合治疗胃癌同时性肝转移临床疗效分析

An analysis on the efficacy of irinotecan combined with tegafur/gimeracil/oteracil in the treatment of gastric cancer with synchronous liver metastasis

目的：回顾性分析伊立替康与替吉奥联合治疗胃癌同时性肝转移临床疗效。方法入组胃癌同时性肝转移患者65例，选用伊立替康联合替吉奥化疗方案：伊立替康180 mg／m2，静滴，d1；替吉奥胶囊60 mg／m2，2次／d，d1～d14。每个周期21天，经4个周期化疗后进行疗效评价分析。结果此组65例患者中3例完全缓解，18例部分缓解，25例疾病稳定，19例疾病进展。临床有效率32．3％（21／65），疾病控制率70．8％（46／65），中位缓解期为6．8个月，中位生存期为9．7个月。此组患者不良反应为：①恶心、呕吐Ⅰ／Ⅱ度（63．0％）；②严重中性粒细胞减少Ⅲ／Ⅳ度（38．2％）；③延迟性腹泻发生率为74．5％，其中严重36．0％（Ⅲ／Ⅳ度）；④脱发Ⅰ／Ⅱ度（58．7％）；⑤其他：口腔黏膜炎、皮肤毒性等（23．0％）。结论立替康与替吉奥联合方案治疗胃癌同时性肝转移疗效确切，不良反应基本可耐受，对于胃癌同时性肝转移患者有一定的临床应用价值。

Objective To retrospectively analyze the efficacy of irinotecan combined with tegafur/gimeracil/oteracil （ S-1） in the treatment of gastric cancer with synchronous liver metastasis.Methods A total of 65 gastric cancer pa-tients with synchronous liver metastasis were included and administrated with a combination of irinotecan （ ivgtt, 180 mg/m2, D1） and S-1 （capsule, 60 mg/m2, twice per day, D1-14）.The course of treatment was 21 days, and after 4 courses, the therapeutic efficacy was assessed.Results Among the patients were 3 CR cases, 18 PR cases, 25 NC or SD cases, and 19 PD cases.The clinical efficiency rate was 32.3% （21/65）.The disease control rate was 70.8%（46/65）.The time of median remission was 6.8 months and the median survival period was 9.7 months.During the study, reported adverse reactions included nausea and vomiting （Ⅰ/Ⅱ grade, 63.0%）, severe neutropenia （Ⅲ/Ⅳgrade, 38.2%）, delayed diarrhea （with an incidence of 74.5%, and 36.0% for Ⅲ/Ⅳ grade）, hair loss （Ⅰ/Ⅱgrade, 58.7%） and other problems like oral mucositis and skin toxicity （23.0%） .Conclusions Irinotecan and S-1 can be combined used for treatment of gastric cancer patients with synchronous liver metastasis.The reported adverse re-actions can be tolerated.The combined therapy can be applied in clinical setteing.