吉西他滨联合氟尿嘧啶类药物治疗耐药性晚期结直肠癌的临床观察

目的　观察吉西他滨（ＧＥＭ）联合氟尿嘧啶类药物治疗耐药性晚期结直肠癌（ｍＣＲＣ）的有效性和安全性。方法　３２例二线及二线以上方案化疗失败的ｍＣＲＣ患者，使用ＧＥＭ（１０００ｍｇ／ｍ^２，ｄ_１、ｄ_８）联合氟尿嘧啶（５-ＦＵ５００ｍｇ／ｍ^２，ｄ_１～ｄ_５）１３例，联合卡培他滨（１２５０ｍｇ／ｍ^２，ｄ_１～ｄ_１４）１９例，直至疾病进展或出现不可耐受的不良反应，每２个周期按照ＲＥＣＩＳＴ标准（１.０版）进行疗效评价，按ＮＣＩ-ＣＴＣ（３.０版）评价毒性并随访生存情况。结果　３２例均可评价疗效和毒性，其中获ＰＲ４例，ＳＤ１４例，ＰＤ１４例，疾病控制率（ＤＣＲ）为５６.３％，中位肿瘤进展时间（ｍＴＴＰ）为３.８个月，中位总生存时间（ｍＯＳ）为８.１个月。主要毒副反应为骨髓抑制、皮疹及发热，多为１～２级，支持对症处理可以恢复。结论　ＧＥＭ联合氟尿嘧啶类药物治疗国人耐药性ｍＣＲＣ具有一定疗效，不良反应可以耐受，值得进一步研究。

Clinical observation on gemcitabine combined with fluorouracil and its analogues in tolerated patients with advanced colorectal cancer

Objective To observe the efficacy and side effects of gemcitabine combined with flurouracil and its analogues in tolerated patients with advanced colorectal cancer.Methods Thirty-two patients who failed in normal chemotherapy were treated with gemcitabine based regimen,13 cases were combined with fluorouracil,while 19 cases were combined with capecitabine.All patients were evaluated according to RECIST criteria every 2 cycles and survival status were also visited at regimen.Results All cases could be evaluated,4 cases achieved PR,14 cases achieved SD and 14 cases got PD.The total disease control rate was 56.3%,median time to progression was 3.8 months and median overall survival time was 8.1 months.The major adverse events were bone marrow suppression,skin rash and fever.Most of them were grade 1-2 toxicities,and could be recovered by symptomatic treatments.Conclusion Gemcitabine combined with flurouracil and its analogues for patients with advanced colorectal cancer is effective and well tolerated,and deserves further clinical research.