不同5-FU剂量的FOLFIRI方案联合西妥昔单抗治疗转移性结直肠癌的疗效观察

The Curative Effect Observation of Different Dosages 5-FU FOLFIRI Scheme Combined with Cetuximab in Metastatic Colorectal Cancer

目的:探讨不同5-FU剂量的FOLFIRI方案联合西妥昔单抗治疗转移性结直肠癌的疗效。方法:分析我院含5-FU的FOLFIRI方案联合西妥昔单抗治疗转移性结直肠癌患者的24例,并对剂量限制性毒性、疗效、耐受性及不良反应进行评价。结果:LD 5-FU的治疗没有发生剂量限制性毒性症状,HD 5-FU的治疗中6.7%患者发生剂量限制性毒性症状。西妥昔单抗相关的不良事件患者数占总人数的45.8%,严重的不良事件患者数占总人数的33.3%。LD或HD的5-FU处理组的最佳总客观有效率分别为55.5%和53.3%,病情控制率分别为88.8%和93.3%,有效持续期分别为3.2~11.8个月和7.6~13.2个月。结论:西妥昔单抗联合每2周的伊立替康和改良的FOLFIRI方案中通常剂量5-FU或FA,形成的高剂量5-FU方案可以安全的应用于转移性结直肠癌患者的治疗;西妥昔单抗联合FOLFIRI方案在转移性结直肠癌临床治疗中可提高耐受性与疗效。

Objective：To study the effects cetuximab in combination with irinotecan/5-fluorouracil/folinic acid in the initial treatment of metastatic colorectal cancer.Methods：Analysis the 24 persons whom have metastatic colorectal cancer and treatmented by cetuximab in combination with irinotecan/5-fluorouracil/folinic acid and conformed the doselimiting toxicities,tolerability and efficacy.Results：No DLTs were reported in the LD group,6.7% of patients in the HD group experienced DLTs.Cetuximab-related grade 3/4adverse events were reported in 45.8% of patients,and serious adverse events were reported in 33.3% of patients.LD and HD groups＇ overall response rate were 55.5% and53.3%,disease control rates were 88.8% and 93.3%,PFS were 3.2~11.8months and 7.6~13.2months,respectively.Conclusion：Cetuximab could be safely combined with 2-weekly irinotecan and the usual dose of 5-FU in the modified FOLFIRI-regimen/FA,which formed the high dose 5-FU-regimen of this study.This combination of cetuximab and the FOLFIRI regimen was associated with promising efficacy and good tolerability in the first-line treatment of mCRC