改良FOLFIRI方案二线治疗老年晚期胃癌患者的临床观察  

Modified FOLFIRI regimen as second-line chemotherapy for elderly patients with advanced gastric cancer

作　　者：乐薇[1] 项晓军[1] 张凌[1] 熊建萍[1] 

机构地区：[1]南昌大学附属第一医院肿瘤科,江西南昌330006

出　　处：《实用肿瘤杂志》2013年第2期200-203,共4页Journal of Practical Oncology

摘　　要：目的评价改良FOLFIRI方案二线治疗老年晚期胃癌的临床疗效及不良反应。方法改良FOLFIRI方案二线治疗45例老年晚期胃癌,具体用法:伊立替康180 mg/m2,d1,静脉滴注90分钟;亚叶酸钙400 mg/m2,d1,静脉滴注2小时;5-FU 2.6 g/m2,亚叶酸钙静脉滴注结束后开始持续泵入46小时,21天为1周期。每2周期按RECIST 1.0标准评价疗效,所有患者至少接受2周期化疗。结果 45例患者共接受化疗120周期(中位4周期),所有患者均可评价疗效。完全缓解0例(0%),部分缓解8例(17.8%),稳定16例(35.5%),病情进展21例(46.7%),疾病控制率为53.3%,中位TTP为3.0月,中位OS为7.9月。最常见的不良反应为血液学毒性,3/4级粒细胞减少、贫血、血小板减少的发生率分别为20.0%、4.4%、2.2%,4.4%的患者出现粒细胞减少性发热。非血液学毒性较轻,1/2级恶心、呕吐反应为44.4%;1/2级腹泻反应为37.8%,3级腹泻反应为2.2%。无化疗相关性死亡病例。结论改良FOLFIRI方案二线治疗老年晚期胃癌患者疗效肯定且不良反应耐受好。Objective To evaluate the efficacy and toxicity of modified FOLFIRI regimen as second-line chemotherapy for elderly patients with advanced gastric cancer. Methods Forty five patients with pathologically confirmed advanced gastric cancer were enrolled in the study. Modified FOLFIRI regimen consisted of irinotecan 180 mg/m2 infused intravenously in 90 rain on dl ,with CF 400 mg/m2 in 2 h ,dl ,followed by a 46 h infusion of 5-FU 2.6 g/m2 every 3 weeks. Efficacy was evaluated by RECIST 1.0 every 2 cycles. Each patient received at least 2 cycles of the chemotherapy. Results All patients were evaluable for efficacy and toxicity. A median of 4 cycles was administered. The disease control rate was 53.3% with CR in 0 （0%）, PR in 8 （ 17.8% ） ,SD in 16 （35.5%） and PD in 21 （46.7%）. Median time to progression was 3.0 months and median overall survival was 7.9 months. The incidences of grade 3/4 neutropenia,anemia, and thrombocytopenia were 20.0% , 4.4% and 2.2% respectively. Febrile neutropenia occurred in 4.4% of patients. Non-hematologic toxicity was fairly mild. Grade 1/2 nausea/vomiting and diarrhea occurred in 44.4% and 37.8% of patients, and grade 3 diarrhea in 2.2%. There was no treatment-related death. Conclusion Modified FOLFIRI regimen is effective and well tolerated as second-line chemotherapy for elderly patients with advanced gastric cancer.

关 键 词：胃肿瘤/药物疗法 氟尿嘧啶/投药和剂量 药物疗法 联合/治疗应用 醛氢叶酸/投药和剂量 

分 类 号：R735.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]