伊立替康联合顺铂治疗原发灶不明癌的临床观察

目的 评价伊立替康联合顺铂方案一线治疗原发灶不明癌的疗效及预后相关因素。方法 72例患者入组，2例患者未治疗，70例患者采用伊立替康联合顺铂方案，伊立替康180 mg/m2，静脉滴注，d1；顺铂75 mg/m2，静脉滴注d1~3,21天为一周期。结果 66例可评价疗效，其中4例CR，24例PR，16例SD，22例PD，ORR（CR+PR）为42.4%。中位至进展时间4.5月，中位生存期10.3月，1、2年生存率分别为38.9%和8.3%。最常见的不良反应包括中性粒细胞减少、恶心和呕吐。体能状况评分0-1、转移部位的数目＜3、局限于淋巴结的患者有更长的生存期（P＜0.05）。结论 伊立替康联合顺铂治疗原发灶不明癌安全而有效。体能状况、转移部位的数目、是否局限于淋巴结为原发灶不明癌的重要预后因素。

Clinical Study of Irinotecan Plus Cisplatin for Patients with Carcinoma of Unknown Primary Site

Objective To evaluate the efficacy and prognostic factors of irinotecan plus cisplatin for patients with carcinoma of unknown primary site (CUP). Methods Seventy-two patients were enrolled. Two patients were not treated with chemotherapy. Seventy cases were treated by irinotecan combined with cisplatin, irinotecan 180 mg/m2, intravenously, d1 and cisplatin 75 mg/m2, d1-d3, intravenously, 21 days for one cycle. Results Sixty-six patients were evaluable for the response. Objective response rate (CR+PR) was 42.4% with 4 complete response(CR), 24 partial response(PR), 16 stable disease(SD) and 22 progressive diseases(PD). The median time to disease progression (TTP) was 4.5 months and the median overall survival (OS) was 10.3 months. The 1- and 2-year survival rates were 38.9% and 8.3%, respectively. The most frequent side effects included neutropenia, nausea and vomiting. The factors of performance status (PS) 0-1, number of metastatic sites <3 and presence of lymphadenopathy were signifi cantly associated with the longer overall survival (P <0.05). Conclusion These results indicate that the combination of irinotecan plus cisplatin is an effective and safe regimen for CUP patients. The PS, number of metastatic sites and presence of lymphadenopathy are only important prognostic factors for CUP.