伊立替康联合氟尿嘧啶/亚叶酸钙治疗转移性结直肠癌

目的观察伊立替康联合亚叶酸钙及氟尿嘧啶方案治疗FOLFOX4方案失败的晚期结直肠癌的临床疗效及毒副反应。方法用CPT-11联合5-FU/CF方案治疗晚期结直肠癌患者28例,采用2周方案化疗,至少2个周期,即CPT-11180mg/m2静脉滴注,第1天;四氢叶酸200mg/m2静脉滴注,第1、2天;5-FU400mg/m2静脉推注,第1、2天;5-FU600mg/m2静脉滴注22h,第1、2天。按照WHO实体瘤近期客观疗效评定标准进行评价。结果全组28例患者均可评价疗效及不良反应。其中完全缓解0例,部分缓解10例,稳定9例,进展9例,有效率为35.7%。中位肿瘤进展时间TTP6.5个月,中位生存时间MST为12.5个月。不良反应主要是骨髓抑制,恶心、呕吐,脱发及延迟性腹泻。结论伊立替康联合5-FU/CF为二线治疗晚期结直肠癌安全有效的方案。

Irinotecan Combined with Fluorouracil/Leucovorin for Metastatic Colorectal Cancer Treatment

Objective To evaluate the efficacy and toxicity of irinotecan(CPT-11)combined with leucovorin and 5-fiuorouracil in the treatment of advanced metastatic colorectal cancer,in which FOLFOX4 had failed to cure it.Methods 28 cases of melastatic colorectal cancer patients were treated by CPT-11 combined with 5-FU/CF for one cycles every two weeks,and at least 2 cycles;CPT-11 was given by 180mg/m2,iv,the first day;CF200mg/iv,the first 1,2 days,5-fu by 400 mg/m2,iv,the first 1,2 days,and 5-fu by 600mg/m2,iv,22h,the first 1,2 days.They were assessed on basis of WHO evaluation standed of objective therapeutic effect for solid tumor.Results 28 patients were assessable to observe the efficacy and safety.0 patients achieved complete remission CR,10 patients partial remission PR,9 patients stable disease SD,9 patients progression disease PD.Overall response rate was35.7%.The median time toprogression mTTP was 6.5months.The median survival time MST was 12.5 months.The majority of adverse reaction were leucopenia,nausea,vomiting,hair loss and diarrhea.Conclusion The second-line chemotherapy with acombination of irinotecan and 5-fiuorouracil/leucovorin is effective and well tolerated by patients with advanced metastatic colorectal cancer.