2种FOLFIRI方案治疗晚期结直肠癌不良反应分析  

Analysis of adverse effects related to two different FOLFIRI regimens in patients with advanced colorectal cancer

作　　者：刘慧龙[1] 王飞[1] 刘彦芳[1] 李红英[1] 

机构地区：[1]北京军区总医院肿瘤科,北京100700

出　　处：《中国新药杂志》2013年第17期2093-2096,2102,共5页Chinese Journal of New Drugs

摘　　要：目的:观察和分析2种FOLFIRI方案治疗晚期结直肠癌相关不良反应发生情况,以期提高治疗的安全性。方法:应用2种FOLFIRI方案治疗晚期结直肠癌患者121例,观察和记录临床常见不良反应发生情况,分析不良反应与患者临床资料及治疗方案的关系。结果:迟发性腹泻(43.8%)和粒细胞减少(42.1%)是主要剂量限制性毒性,5例因严重腹泻,4例因重度骨髓抑制退出治疗;≥60岁老年患者胆碱能综合征发生率较<60岁患者明显增加(75.0%vs 54.3%,P=0.028);女性较男性患者恶心/呕吐发生率更高(68.8%vs 49.3%,P=0.024);二线治疗患者粒细胞细胞减少更为常见(46.1%vs 26.7%,P=0.029);改良FOLFIRI方案患者除黏膜炎外(47.1%vs 27.5%,P=0.028),其余不良反应与经典的FOLFIRI方案相仿。结论:2种FOLFIRI方案治疗晚期结直肠癌总体安全性均较好,改良的FOLFIRI方案可以替代经典方案常规应用。Objective： To observe and analyze adverse effects related to two different FOLFIRI regimens in patients with advanced colorectal cancer.Methods： A total of 121 patients with advanced colorectal cancer were assigned to receive two FOLFIRI regimens.The incidence of adverse effects was recorded.The correlation between clinical characteristics of the adverse effect development and chemotherapy regimens was analyzed.Results： Delayed-onset diarrhea（43.8%） and neutropenia（42.1%） were major dose-limited toxicity.Five patients with severe diarrhea and 4 patients with serious myelosuppression were withdrawn from the study.Cholinergic symptoms were more common in senior patients（75.0% vs 54.3%,P = 0.028） and nausea / vomiting were more common in female patients（68.8% vs 49.3%,P = 0.024）.Other adverse effects of modified FOLFIRI were similar to those of classic FOLFIRI,except for mucocitis（47.1% vs 27.5%,P = 0.028）.Conclusion： Both different FOLFIRI regimens can be safely used for treating advanced colorectal cancer and the modified FOLFIRI can be a suitable substitute for classic FOLFIRI.

关 键 词：伊立替康 结直肠癌 化学治疗 不良反应 

分 类 号：R979.1[医药卫生—药品]