雷替曲塞联合伊立替康2周方案对比FOLFIRI方案二线治疗晚期结直肠癌的疗效观察  

Clinical observation of raltitrexed combination with irinotecan versus FOLFIRI regimen as second-line treatment for advanced colorectal cancer

作　　者：谢达成[1] 李宁[1] 王静珏 江卫华[1] 王理伟[1] 周翡[1] 

机构地区：[1]上海交通大学附属第一人民医院肿瘤内科,上海200080

出　　处：《临床肿瘤学杂志》2013年第2期140-143,共4页Chinese Clinical Oncology

摘　　要：目的观察雷替曲塞联合伊立替康2周方案治疗转移性结直肠癌的有效性和安全性。方法经病理组织学或细胞学确诊的50例晚期转移性结直肠癌患者分为试验组(n=25)和对照组(n=25)。试验组方案:雷替曲塞2.5mg/m2静滴,d1;伊立替康(CPT-11)180mg/m2静滴,d1。对照组方案:CPT-11 180mg/m2静滴90min,d1;亚叶酸钙400mg/m2静滴,d1;5-FU 400mg/m2静滴,d1;5-FU 2400mg/m2持续静滴46～48 h,d1、d2。两方案均2周为1周期,每周期评价毒副反应,每3个周期评价疗效,直至疾病进展或毒性不能耐受,最多治疗12个周期。结果试验组获CR 1例,PR 4例,SD 18例,PD 2例;对照组获PR 2例,SD 19例,PD 4例。两组有效率(RR)分别为20%和8%,疾病控制率(DCR)分别为92%和84%,差异均无统计学意义(P>0.05)。试验组1、2级转氨酶升高的发生率为24%,高于对照组的4%(P<0.05);对照组1、2级中性粒细胞减少、口腔黏膜炎的发生率均高于试验组(48%vs.20%,32%vs.8%,P<0.05)。结论雷替曲塞联合伊立替康2周方案与FOLFIRI方案的近期疗效相当,但毒副反应更轻,可以作为转移性结直肠癌的有效姑息治疗方案。Objective To compare the efficacy and safety between biweekly raltitrexed and irinotecan with FOLFIRI for pa- tients with metastatic colorectal cancer. Methods A total of 50 patients with metastatic colorectal carcinoma were included into the study. There were 25 patients for irinotecan plus raltitrexed regimen group （treatment group： rahitrexed 2. 5mg/m2 iv d1, irinotecan 180mg/m2 iv d1 ） and 25 patients for FOLFIRI group（ control group： irinotecan 180mg/m2 iv d1, leucovorin 400mg/m2 iv d1, fluorou- racil 40Omg/m2 iv dj , fluorouracil 2400mg/m2 iv 46-48 h）. Both two regimens were 14 days as a cycle,and a total of 12 cycles was applied unless there was evidence of disease progression or intolerance of treatment. The efficacy was evaluated every 3-cycle chemo- therapy and side effects were evaluated every cycle. Results Patients in treatment group received 1 CR, 4 PR, 18 SD, 2 PD; and in control group were 2 PR, 19 SD, 4 PD. No statistical difference was found between two groups in regard to response rate （20% vs. 8% ） and disease control rate（92% vs. 84% ）. Raltitrexed and irinotecan regimen had higher frequency of grade 1-2 transaminase in- crease（24% vs. 4% ,P 〈0. 05）, while FOLFIRIF regimen had higher frequency of grade 1-2 neutropenia（48% vs. 20%, P 〈0. 05） and mucositis （32% vs. 8%, P 〈 O. 05）. Conclusion Rahitrexed and irinotican regimen is effective for metastatic colorectal cancer. It has lower toxicity compared with FOLFIRI regimen.

关 键 词：结直肠癌 雷替曲塞 伊立替康 化学治疗 

分 类 号：R735.3[医药卫生—肿瘤]