Avastin联合FOLFIRI治疗晚期肠癌的临床观察  

Efficacy of Bevacizumab combined with FOLFIRI in the treatment of refractory metatastic colorectal cancer

作　　者：王继荣[1] 李娟[1] 陆彬彬[1] 樊英瑞[1] 林岩[1] 王朝霞[1] 王科明[1] 

机构地区：[1]南京医科大学第二附属医院肿瘤科,江苏南京210011

出　　处：《现代肿瘤医学》2013年第3期578-581,共4页Journal of Modern Oncology

基　　金：江苏省卫生厅科研项目资助(编号:H200913);江苏省普通高校研究生科研创新计划项目(编号:CXLX11-0725)

摘　　要：目的:比较Avastin(贝伐单抗)联合FOLFIRI化疗方案(伊立替康+亚叶酸钙+5-氟尿嘧啶)与单用FOLFIRI化疗方案二线治疗晚期结肠癌的临床疗效。方法:28例经组织病理学证实的晚期结肠癌患者,随机分组。Avastin联合FOLFIRI治疗组12例:Avastin后于化疗药物使用,化疗后第二天使用,用量为5mg/kg。首次应用Avastin静脉滴注90min以上,如果第1次滴注耐受良好,第2次滴注可为60min以上,如果60min也耐受良好,以后的滴注可控制在30min以上。FOLFIRI方案:伊立替康180mg/m2静脉滴注d1,四氢叶酸钙注射液200mg/m2静脉滴注2h,d1-2,5-FU 400mg/m2静脉推注d1-2;600mg/m2持续静脉输注22h,d1-2。2周重复用药。对照组16例,单用FOLFIRI方案进行化疗。比较2组近期疗效、无进展生存期和安全性。结果:临床有效率两组分别为25.00%和18.75%;无进展生存期6.625±0.547月和5.25±0.403月,联合化疗方案明显优于单用化疗方案(P<0.05)。不良反应有腹泻、骨髓抑制、恶心呕吐、高血压等,但2组差异无统计学意义。结论:Avastin联合FOLFIRI化疗方案治疗晚期结肠癌能有效延长无进展生存期。较单用FOLFIRI化疗方案,不良反应无明显增加,患者可以耐受。Objective：To compare the effects of single used FOLFIRI and its combination with Bevacizumab in the treatment of refractory metatastic eolorectal cancer. Methods： Twelve histopathology confirmed patients with ad- vanced cotorectal cancer were selected as treatment group received the treatment of Bevacizumab plus FOLFIRI. An- other sixteen patients were the control group received the treatment of FOLFIRI alone. Bevaeizumab was used after chemotherapy in treatment group. Bevaeizumab intravenous drip by 5mg/kg. First time Bevaeizumab continue to intra- venous drip 90 min. Bevaeizumab was used more than 4 times. FOLFIRI： Irinotecan 180mg/m2 intravenous infusion dI ,leucovorin 200mg/m2 intravenous infusion d1 and d2 ,5 -FU 400mg/m2 bolus dI and d2 ;600mg/m2 continuous in- travenous d1 and d2. Repeated every 2 weeks. Results： The clinical efficacy in the treatment and control groups were25.00% and 18.75%. Time to progress in, the treatment and control groups were 6. 625 ＋ O. 547 and 5.25 ＋ O. 403 months. Bevacizumab combined with FOLFIRI was superior to FOLFIRI alone. Difference between these two groups was statistically significant （P 〈 0.05 ）. The main adverse reactions were marrow suppression, diarrhoea, nausea and vomit, and high blood pressure. There was no significant difference （P 〉 0.05）. Conclusion： Time to progress of Bev- acizumab combined with FOLFIRI is longer than FOLFIRI alone for the patients with advanced colorectal cancer. The toxicity between these two groups is similar and the patients can be tolerated.

关 键 词：贝伐单抗(Avastin) 化疗 大肠癌 

分 类 号：R735.34[医药卫生—肿瘤]