伊立替康联合替莫唑胺对儿童难治性实体瘤近期疗效的研究  

Irinotecan Plus Temozolomide for Relapsed or Refractory Pediatric Solid Tumor

作　　者：司绍永[1] 仲任[1] 孙立荣[1] 徐慧娟[1] 李学荣[1] 庞秀英[1] 

机构地区：[1]青岛大学医学院附属医院小儿血液科,山东青岛266003

出　　处：《现代生物医学进展》2011年第15期2948-2951,共4页Progress in Modern Biomedicine

摘　　要：目的:研究伊立替康(Irinotecan,CPT-11)联合替莫唑胺(Temozolomide,TMZ)对儿童难治性实体瘤的近期疗效;方法:选取了11名难治性儿童实体瘤患者并争取了家属同意,分别给予了伊立替康:60mg/m^2/d,ivgtt,连用5天;替莫唑胺:75mg/m^2/d,连用5天,在伊立替康前一小时口服;用药期间同时给予思密达或者头孢菌素类抗生素预防药物相关性腹泻,并定期复查血象以及肝肾功;28天一疗程,每疗程行复查CT或MRI进行疗效评定和药物安全性评价。结果:11例患者经过2-6个疗程的治疗;疾病控制率(DCR)达到54%;明显延长了患者的无疾病进展生存期,中位无疾病进展生存期3.3个月。用药期间不良事件主要包括0-Ⅲ级的药物相关性腹泻、呕吐、血小板减少、贫血等;结论:伊立替康联合替莫唑胺方案能明显延长儿童难治实体瘤患者未进展存活时间,且耐受性好、安全性高,可以作为儿童晚期实体瘤患者的首选治疗方案。Objective： To analyze the lately thorapeutic effect of Irinotecan combined Temozolomide in children with recurrent/ resistant solid tumor. Methods： A total of 11 patients received oral temozolomide 75mg/m2/d on days 1, through 5 combined with intravenous Irinot＇ecan 60mg/m2/d on days 1 to 5 in 3 weeks courses. Daily oral cefaclor was used to reduce irinotecan -associated diarrhea. Meantime, clinical experience and contrast enhanced CT or MRI scan were performed every course. Rcstt!ts： All the patients received two to six courses oflrinotecan and Temozolomide;six（54%） of 11 patients had response or disease s^bi｜~al^ion ha three courses; the me- dian progression-free survival for 11 patients who began treatment was about 3.3 months. The dose-limiting toxicity（DLT） includes grade 0 to III diarrhea,nausea, anaemia, thrombocytopenia, etc. Conclusion： The regiment can evidently prolong the progression free survival time of patients with refractory solid tumor; peoples with the regiment treatment experienced better quality of life and fewer adverse drug events; The regiment can be made the first-line treatment for relapsed or refractory pediatric solid tumor.

关 键 词：伊立替康 替莫唑胺 实体瘤 

分 类 号：R730.5[医药卫生—肿瘤]