周剂量伊立替康二线治疗晚期转移性胃肠癌疗效观察  

Clinical Observation of Weekly Irinotecan as Second-Line Treatment of Patients with Metastatic Gastrointestinal Cancer

作　　者：黄建国[1] 陆建伟[2] 

机构地区：[1]沛县人民医院肿瘤内科,江苏徐州221600 [2]江苏省肿瘤医院内科,江苏南京210009

出　　处：《肿瘤基础与临床》2009年第2期125-127,共3页journal of basic and clinical oncology

摘　　要：目的周剂量伊立替康（CPT-11）联合5-氟脲嘧啶（5-Fu）及醛氢叶酸（LV）组成二线化疗方案，治疗一线化疗失败后的转移性胃肠癌患者，观察缓解率、安全性及生存期。方法入组病例为转移性胃肠癌经一线化疗失败后的患者，CPT-11 60 mg/m^2，LV100 mg/m^2，5-Fu 500 mg/m^2，每周1次，连续3周，每4周重复，每例至少接受2个疗程后评价疗效，患者最多接受6个疗程。结果全组29例，25例肠癌中，CR 0例，PR 5例（20.0%），SD 9例（36.0%），PD 11例（44.0%），总有效率（CR＋PR）为20.0%，疾病控制率为56.0%；4例胃癌中未见有效病例。所有患者的疾病进展时间为2-10个月，中位疾病进展时间4.0个月，生存期为5-28个月，中位生存期9.0个月。Ⅲ-Ⅳ度呕吐发生率34.5%，Ⅲ-Ⅳ度迟发性腹泻发生率为27.6%。结论周剂量CPT-11联合5-Fu/LV为治疗晚期转移性结直肠癌有效的二线方案，毒副反应轻微，可供临床安全使用。Objective We observed the survival situation, efficacy and safety of irinotecan plus 5-Fu/LV after first-line chemotherapy failure with advanced or/and metastatic gastrointestinal cancer. Methods Twenty nine patients with metastatic gastrointestinal cancer whose disease had progressed after treatment with first-line chemotherapy were included to receive weekly regimen （ irinotecan 60 mg/m^2 , LV 100 mg/ m^2 , 5-Fu 500 mg/m^2）. Results 25 coloreetal cancers were assessable to observe the efficacy and safety. No case was CR. 5 cases were PR, response rate was 20.0% （5/25）. 9 cases were SD, rate was 36.0% （9/25）. 11 cases were PD, rate was 44.0% （11/25）. Median time to progression （TTP） was 4.0 months （2 to 10 months）, median overall survival was 9.0 months（5 to 28 months）. The majority of adverse reactions were nausea, vomiting, anorexia, diarrhea, leucopenia, alopecie. Most of them were Ⅰ / Ⅱ degree. Conclusion The weekly regimen of irinotecan in combination with 5-Fu/LV results in significant and clinically meaningful improvement in survival and quality of life among patients with metastatic gastrointestinal cancer. Toxicity is manageable.

关 键 词：伊立替康 二线化疗 晚期胃肠道癌 

分 类 号：R735.2[医药卫生—肿瘤]