雷替曲塞联合伊立替康一线治疗复发或转移性胃癌的临床观察

目的：观察雷替曲塞联合伊立替康方案一线治疗复发或转移性胃癌的疗效及不良反应。方法选取2014年1月至2015年3月在江苏省张家港市第一人民医院接受治疗的39例复发或转移性胃癌患者，方案为雷替曲塞3．0 mg／m2，15 min 静脉滴注，第1天，伊立替康180．0 mg／m2，90 min 静脉滴注，第1天，21 d 为一周期，每2周期评价疗效，每个周期评价不良反应。结果39例患者均可评价疗效和不良反应，完全缓解0例，部分缓解16例，病情稳定11例，疾病进展12例，有效率为41．03％（16／39），疾病控制率为69．23％（27／39），中位生存时间为9．3个月（95％CI 为8．8～11．1个月），中位无疾病进展生存时间为6．0个月（95％CI 为5．1～6．8个月）。最常见的不良反应为中性粒细胞减少、贫血、肝功能异常，发生率分别为35．90％、33．33％、28．21％。结论雷替曲塞联合伊立替康一线治疗复发或转移性胃癌疗效肯定，不良反应可耐受，值得进一步临床研究。

Clinical observation of raltitrexed combined with irinotecan as first-line chemotherapy for recurrent or metastatic gastric cancer

Objective To observe the efficacy and adverse reaction of raltitrexed combined with irino-tecan as first-line chemotherapy for recurrent or metastatic gastric cancer.Methods From January 201 4 to March 201 5,39 patients of recurrent or metastatic gastric cancer who received treatment in the First People′s Hospital of Zhangjiagang of Jiangsu Province were collected.All patients received raltitrexed (3.0 mg/m2 , 1 5 min intravenous drip)on the first day and irinotecan (1 80.0 mg/m2 ,90 min intravenous drip)on the first day.One cycle lasted 21 days.The efficacies were evaluated every 2-cycle.Adverse reactions were evaluated every cycle.Results The efficacies and adverse reactions could be evaluated in 39 patients.The study received 0 complete remission,1 6 partial remission,1 1 stable disease,1 2 progression disease.The objective response rate was 41 .03% (1 6 /39).The disease control rate was 69.23% (27 /39).The median overall sur-vival time was 9.3 months (95%CI:8.8-1 1 .1 months).The median progression-free survival time was 6.0 months (95%CI:5.1 -6.8 months).The adverse reactions were mainly neutropenia,anemia,liver dysfunc-tion,the incidence of them were 35.90%,33.33% and 28.21 % respectively.Conlusion Raltitrexed com-bined with irinotecan as first-line chemotherapy for recurrent or metastatic gastric cancer acquires an definite efficacy,and the adverse reactions can be tolerated,which is worthy of further clinical research.