开普拓+希罗达方案介入及全身化疗治疗大肠癌肝转移的临床疗效  

Effects of systemic and interventional chemotherapy with CPT-11 + xeloda for the liver metastasis from colorectal carcinoma

作　　者：王馨[1] 吴炜新[1] 吕霞[1] 苏安[1] 肖莉[1] 

机构地区：[1]厦门大学医学院中山医院肿瘤科,福建厦门361004

出　　处：《现代肿瘤医学》2007年第8期1153-1155,共3页Journal of Modern Oncology

摘　　要：目的:评价开普拓+希罗达方案(XELILI方案)介入及全身化疗治疗大肠癌肝转移的疗效及毒副作用。方法:病理确诊的大肠癌患者50例,其中45例为根治术后FOLFOX4方案化疗后出现肝转移,5例为初治者。术前常规检查除外治疗禁忌症并CT扫描测量肝转移灶大小,予以开普拓+希罗达方案介入栓塞化疗序贯全身化疗,开普拓用量:180mg/m2,碘化油10ml～20ml,希罗达2000mg/m2,分两次口服,连服14天,休息7天,21天一周期。2周期后复查血常规、肝肾功能、腹部CT,判断疗效及是否进一步介入治疗,若肝转移灶及原发灶CR,继续静脉点滴开普拓,口服希罗达化疗至6个周期;PR者经皮肝穿瘤内注射盐酸;PD者改含贝伐单抗方案化疗。结果:CR8例,PR25例,SD10例,PD7例,总有效率为66%(34/50),主要毒副反应为栓塞后综合征、急性胆碱能综合症及骨髓抑制,5例出现轻中度肝功能损害,4例迟发性腹泻。随访3年,疾病进展时间为7个月,中位生存期为25个月。结论:开普拓+希罗达方案介入结合全身治疗大肠癌肝转移是安全、有效的,但两者配合的标准方案尚待研究。Objective ：To evaluate the therapeutic effects of systemic and interventional chemotherapy with CPT - 11 ＋ xeloda （XELILI regimen） for the liver metastasis from colorectal carcinoma. Methods： Among the 50 cases with pathologically diagnosed colorectal carcinoma, there were 45 cases found liver metastasis after curative surgical operation tveating with FOLFOX4 chemotherapy regimen treatment, and 5 cases undergone no prior chemotherapy. All patients were treated with XELILI regimen by intravenous injection and transhepatic arterial chemoembolization with XELLILI regimen ： CPT - 11 180mg/m^2, the cycles was 21 days ; xeloda 2000mg/m^2divided into 2 shares for orally taking for 14 days, followed with 7 days interval. The effect was evaluated after 2 cycles by blood routine, hepatic function, renal function and abdominal CT scan. Cases with liver metastasis CR were treated with CPT - 11, ivgtt and xeloda, po, PR with hydrochloric acid injection in the liver metastasis ; PD with avastin - based reqimen. Results： Among the total 50 cases , there were CR 8 PR25, SD10, PD7, with an overall response rate of 66% （ 33/50 ）, TIP 7months, MST 25 months. The main adverse effects were post -chemoembolization syndrome,5 cases were undergone mild （slight to middle）hepatic function damage in therapeutic group. Conclusion： Systemic and interventional chemotherapy with XELILI regimen for the liver metastasis from colorectal carcinoma is safe and effective, but the standard regimen composed of XELILI is remained to be studied.

关 键 词：介入治疗 大肠癌 肝转移 化学治疗 

分 类 号：R735.34[医药卫生—肿瘤]