伊立替康联合卡培他滨在奥沙利铂化疗后进展的晚期结直肠癌患者中的疗效和安全性  

Efficacy and Safety of Combination of Irinotecan and Capecitabine in Patients with Metastatic Colorectal Cancer after Failure of Chemotherapy with Oxaliplatin

作　　者：周建凤[1] 白春梅[1] 程月鹃[1] 贾宁[1] 邵亚娟[1] 陈书长[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院肿瘤内科,北京100730

出　　处：《中国医学科学院学报》2009年第3期358-361,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的评估伊立替康(CPT-11)联合卡培他滨(Xeloda)(CAPIRI方案)在奥沙利铂(OXA)化疗后进展的晚期结直肠癌患者中的疗效和安全性。方法以OXA化疗失败的38例晚期结直肠癌患者为研究对象,采用CAPIRI方案治疗,具体为:Xeloda2000mg/(m2.d),每日2次口服,共14d;第1、8天,90min内静脉滴注CPT-11100mg/m2;每3周重复1次。观察患者的疗效和不良反应。结果38例患者在确诊Ⅳ期后中位时间11.0个月开始应用CAPIRI方案,其中二线治疗33例,三线治疗4例,四线治疗1例,共完成121个周期化疗,中位周期数3.0。34例可评估疗效,有效率5.9%,疾病控制率61.8%,中位至疾病进展时间4.5个月,中位生存期11.0个月。38例均可评价安全性,最常见不良反应为白细胞减少(73.7%)、中性粒细胞减少(65.8%)、恶心呕吐(60.5%)和腹泻(28.9%),Ⅲ/Ⅳ度发生率分别为10.5%、13.2%、10.5%和7.9%,总体耐受性好。结论CAPIRI方案可安全有效地应用于OXA联合化疗后失败的晚期结直肠癌患者。Objective To evaluate the efficacy and safety of irinotecan combined with xeloda （ CAPI- RI regimen） in patients with metastatic colorectal cancer after failure of chemotherapy with oxaliplatin. Methods Totally 38 patients with metastatic colorectal cancer after failure of chemotherapy with oxaliplatin were enrolled. Patients received xeloda 1 000 mg/m^2 orally twice daily on day 1 to 14 and intravenous irinotecan 100 mg/m^2 on day 1 and 8 every 3 weeks. Results The median age of 38 patients was 58.5 （27-77） years. CAPIRI regimen was used 11.0 （3.0-24. 0） months after the diagnosis of metastatic colorectal cancer （CAPIRI regimen as second-line chemotherapy in 33 patients, third-line in 4 patients, and fourth-line in 1 patient）. A total of 121 cycles of chemotherapy （median 3.0） were administered. Thirty-four patients were evaluable for response. The overall response rate and disease control rate were 5.9% and 61.8% , respectively. The median time to progression and overall survival were 4.5 months （95% CI, 3.4-5.6 months） and 11.0 months （95% CI, 10.2-11.8 months） , respectively. All 38 patients were evaluable for safety. The most common adverse events were leukopenia （73.7%）, neutropenia （65.8%）, nausea and vomiting （60.5%）, and diarrhea （28.9%）. The occurrence rates of these grade 3-4 events were 10.5% , 13.2% , 10.5% , and 7.9% , respectively. All adverse events were tolerable. Conclusion CAPIRI regimen is effective and well-tolerated in Chinese patients with metastatic colorectal cancer after failure of chemotherapy with oxaliplatin.

关 键 词：伊立替康 卡培他滨 奥沙利铂 晚期结直肠癌 疗效 安全性 

分 类 号：R735.34[医药卫生—肿瘤]