伊立替康联合5氟尿嘧啶或卡培他滨治疗消化系统肿瘤的回顾性分析

目的探讨伊立替康联合氟尿嘧啶类药物在晚期结直肠癌、胃癌治疗中的疗效和不良反应。方法 28例消化系统肿瘤患者采用伊立替康为主联合化疗方案治疗。伊立替康用药剂量为69 mg/m2～200 mg/m2,中位周剂量强度为80 mg/m2。治疗周期1～22个不等,平均治疗周期数为4.5个,观察指标,进行疗效评价。结果初步观察结果显示,以伊立替康为主的联合化疗方案在贲门癌、胃癌、结直肠癌的有效率为54.5%。发生急性胆碱能综合症3例(11.7%),5例(17.9%)患者发生Ⅰ度腹泻,4例(14.3%)发生Ⅱ度腹泻,经易蒙停干扰后继续治疗;2例(7.1%)发生出现Ⅲ度腹泻。结论以伊立替康为主的联合化疗方案在贲门癌、胃癌、结直肠癌有效,腹泻与治疗剂量强度密切相关,急性胆碱能综合征通过延长输注时间得以缓解。

Analysis of colorectal and gastric cancer patients with chemotherapy of irinotecan combined fluoropyrinide

Objective To analyzed retrospectively the advanced esophageal cancer,cardia cancer,gastric cancer and colorectal cancer patients received irinotecan(CPT)-based chemotherapy and its,side effects,especially acute cholinergic syndrome and diarrhea.Methods From January 2003 to December 2004 received irinotecan(Pfizer)-based combination chemotherapy regimes 28 patients at the Chinese Academy of Medical Sciences & cancer hospital.Irinotecan dose 69-200 mg/m2,the median weekly dose intensity of 80 mg/m2,treated by 1-22 cycles.the average treatment of 4.5 cycles.Results Complete response(CR) and partial response(PR) in 9 patients(ORR:CR+PR) 54.5%.Acute cholinergic syndrome occurred in 3 cases(10.7%);Grade Ⅰ diarrhea occurred in 5 patients(17.9%),Grade Ⅱ diarrhea in 5 patients(14.3%),Grade Ⅲ diarrhea in 2 patients(7.1%).Conclusion The irinotecan-based combination chemotherapy in cardia cancer,gastric cancer,colorectal cancer is a effective treatment.Diarrhea closely related to the dose intensity,the acute cholinergic syndrome be alleviated by extending the infusion time.