FOLFIRI方案对草酸铂治疗失败的晚期结直肠癌的疗效分析  

Efficacy of FORFIRI regimen on oxaliplatin-based chemotherapy-failed advanced colorectal cancer

作　　者：李宇红[1,2] 王风华[1,2] 张东生[1,2] 王志强[1,2] 冯芬[1,2] 张力[1,2] 徐瑞华[1,2] 姜文奇[1,2] 何友兼[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心内科,广东广州510060

出　　处：《癌症》2009年第9期913-918,共6页Chinese Journal of Cancer

摘　　要：背景与目的:依立替康(CPT-11)、草酸铂、氟尿嘧啶(5-FU)和卡培他滨是晚期结直肠癌的主要有效化疗药物。目前对于以5-FU或卡培他滨与草酸铂组成的联合化疗方案治疗失败的晚期结直肠癌患者,推荐使用FOLFIRI方案,但国内研究报道的例数较少。本研究的目的是评价FOLFIRI方案治疗草酸铂化疗失败的结直肠癌患者的疗效和安全性,分析不同临床因素对疗效的影响。方法:FOLFOX6方案辅助化疗结束后12个月内进展或既往行FOLFOX6/CapeOX方案一线姑息化疗失败后的晚期结直肠癌患者90例患者纳入研究,接受FORFIRI方案治疗。观察疗效和不良反应。结果:90例患者中81例可评价疗效,其中完全缓解2例,部分缓解20例,稳定34例,总有效率27.2%,疾病控制率69.1%,中位疾病进展时间6.8个月(95%CI,4.9～8.8个月),中位生存时间18.8个月(95%CI,17.5～20.2个月)。主要不良反应为恶心、呕吐、粒细胞下降、脱发、乏力、肝功能损害、口腔黏膜炎、腹泻等,Ⅲ度不良反应包括脱发15例(16.7%)、呕吐10例(11.1%)、恶心8例(8.9%)、粒细胞下降5例(5.6%)、肝功能损害2例(2.2%)和口腔黏膜炎2例(2.2%)。患者可耐受或经积极对症支持治疗可恢复。结论:FOLFIRI方案治疗FOLFOX6或CapeOX治疗失败的晚期结直肠癌可获得较高的临床获益率,患者耐受性良好,是一安全有效、值得广泛应用的方案。Background and Objective： Irinotecan （CPT-11）, oxaliplatin, 5- fluorouracil （5-FU） and capecitabine are main active agents for advanced colorectal cancer. FORFIRI regimen is recommended for the patients who were treated with oxaliplatin plus 5-FU or capecitabine previously. This study was to investigate the efficacy and safety of FORFIRI regimen in treating advanced colorectal cancer failing to prior oxaliplatin-based chemotherapy, and analyze the impacts of clinical factors on the responses. Methods： A total of 90 patients with advanced colorectal adenocarcinoma, who had received prior adjuvant FOLFOX6 regimen and progressed within 12 months after the completion of therapy or had no response to prior FOLFOX6/CapeOX regimen as first-line therapy, were treated with FORFIRI regimen. The efficacy and adverse events were observed. Results： Of the 81 evaluable patients, two achieved complete remission, 20 achieved partial remission and 34 had stable disease. The overall response rate was 27.2% and disease control rate was 69.1%. The median time to progression was 6.8 months （95% CI, 4.9-8.8 months） and median overall survival time was 18.8 months （95% CI, 17.5-20.2 months）. The main adverse events time were nausea, vomiting, neutropenia, alopecia, fatigue, impaired liver function, oral mucositis and diarrhea. Grade Ⅲ adverse events included alopecia in 15 patients （16.7%）, vomiting in 10 patients （11.1%）, nausea in eight patients （8.9%）, neutropenia in five patients （5.6%）, impaired liver function in two patients （2.2%） and oral mucositis in two patients （2.2%）. Conclusion： FOLFIRI regimen is effective and well-tolerated as salvage therapy for advanced colorectal cancer failing to prior FOLFOX6/CapeOX regimen, and thus can be used widely.

关 键 词：结直肠肿瘤 伊立替康 氟尿嘧啶 醛氢叶酸 化学疗法 

分 类 号：R735.34[医药卫生—肿瘤]