FOLFIRI方案对晚期胃癌二线治疗的临床观察

目的观察和评价伊立替康（开普拓，CPT-11）联合氟尿嘧啶（5-Fu）与亚叶酸钙（CF）用于晚期胃癌患者的二线治疗的疗效及毒副反应。方法回顾性分析2004年5月至2008年12月38例晚期胃癌患者接受FOLFIRI方案作为二线治疗的资料。CPT-11给药剂量按180mg／m^2，第1天静滴30min：CF200mg／m^2，第1～2天静滴2h；5一Fu400mgm^2，第1～2天静脉推注；5-Fu600mg／m^2，第1～2天持续静滴22h。每2周为1个周期，每例至少接受3周期化疗后评价疗效。结果全组38例均可评价，有效率[完全缓解（CR）＋部分缓解（PR）]为18．4％（7／38），稳定（SD）26．3％（10／38），进展（PD）55．3％（21／38）。中位疾病进展时间（TTP）3．4个月，中位生存时间（MOS）9．1个月。治疗相关毒副反应主要为中性粒细胞减少及迟发性腹泻。结论FOLFIRI方案二线治疗晚期胃癌疗效肯定，可使部分患者临床获益，其毒副反应可以耐受。

FOLFIRI as second-line chemotherapy for metastatic or relapsed gastric cancer

Objective To evaluate the effect and toxicity of FOLFIRI as second-line treatment for metastatic or relapsed gastric cancer （MRGC）. Methods From May 2004 to December 2008, 38 cases with MRGC were received FOLFIR1 as second-line therapy. CPT-11 was given by 180 mg/m^2 , dl, intravenous drip in 30 minutes ; CF 200 mg/m^2, d1, d2, intravenous drip in 2 hours ; 5-FU 400 mg/m^2, d1, d2, intravenous push ; 5-FU 600 mg/m^2, d1, d2, intravenous drip in 22 hours. Every two weeks was a cycle. Each patient had received at least three cycles chemotherary. Results In 38 patients, 18.4% （7/38） of response rate was observed and SD was 26.3% （ 10/38）, PD was 55.3% （21/38） . TTP was 3.4 months, MOS was 9. lmonths. The common treatment related toxicity were neutropenia and delayed diarrhea. Conclusions FOLFIRI for treating patients with MRGC is an active therapy; it may benefit a part of patients in clinic because of tolerable side effects.