伊立替康联合卡培他滨—线治疗晚期结直肠癌的近期疗效

目的:观察伊立替康(CPT-11)与卡培他滨联合一线治疗晚期结直肠癌的疗效和不良反应。方法:46例晚期结直肠癌病人采用CPT-11+卡培他滨方案治疗即CPT-11250mg·m~(-2)静脉滴注2h,d1给药,21d为一个周期,同时给予卡培他滨1250mg·m~(-2),每日分2次口服,于d1～14用药,21d为—个周期。每例治疗2个周期后进行临床疗效和不良反应评价。结果:可评价疗效40例,完全缓解(CR) 2例,部分缓解(PR)19例,稳定(SD)17例,进展(PD)2例,总有效率(CR+PR)为52％,在11例发生肺转移的病人中PR4例,有效率为36％。全组中位肿瘤进展时间(TFP)为9.6mo,中位生存期20.8mo。全组共完成170个化疗周期其主要不良反应为迟发性腹泻69个周期,占40.6％,其中Ⅲ-Ⅳ度腹泻23个周期,占13.5％;化疗后中性粒细胞减少90个周期,占52.9％,其中Ⅲ-Ⅳ度中性粒细胞减少35个周期,占20.6％和手足综合征1.2％。结论:CPT-11与卡培他滨联合一线治疗晚期结直肠癌是有效的。其主要不良反应是腹泻、中性粒细胞下降和手足综合征。

Short-term effects of irinotecan plus capecitabine as first-line treatment for advanced colorectal carcinoma

AIM:To evaluate the short-term therapeutic efficacy and adverse reaction of irinotecan(CPT- 11)combined with capecitabine as first-line therapy in patients with advanced and metastatic colorectal carcinomas.METHODS:Forty-six patients with advanced or metastatic colorectal carcinoma were treated with CPT-11(250mg·m~(-2))infusion for 2h every 3wk as a cycle in total of no less than six cycles and capecitabine 1250mg·m~(-2)by oral divided into two doses,on d1-14.At least six cycles were administered.RESULTS:In the whole 170 cycles,40 evaluvable patients,2 patients had complete response,19 patients had partial response,17 patients had stable disease and 2 patients with progressive disease.The overall response rate was 52%(21/40).11 patients with lung metastasis there were 4 patients had partial response,the response rate was 36%.Time to progression(TIP)was 9.6 mo and medium overall survival(MOS)was 20.8 mo.In 46 patients with totally 170 cycles of chemotherapy,diarrhea occurred in 69 cycles (40.6%),including 23 cycles (13.5%) in gradeⅢand IV.leucopenia occurred in 90 cycles(52.9%),35 cycles (20.6 %) in gradeⅢand IV.Hand-feet syndrome occurred in 36 cycles(21.2%)and 2 cycles(1.2%)in gradeⅢand IV. CONCLUSION:Combination of CPT-11 and capecitabine is effective and safe in treatment for advanced or metastatic colorectal carcinoma.CPT-11 combined with capecitabine is not only more effective,but also its occurrence of adverse reaction is lower,and are especially high effective for lung metastasis.There in reasonable to recommend that combination of CPT-11 with capecitabine may be as the first choice in treatment for such patients.