复治性晚期结直肠癌多通道编程输液泵IFL方案时辰化疗临床观察  

IFL regimen chronochemotherapy using melodie pump in advanced colorectal cancer patients

作　　者：邬麟[1,2] 殷先利[1,2] 王倩之[1,2] 曾德余[1,2] 曹军[1,2] 周慧俊[1,2] 蒲兴祥[1,2] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院 [2]湖南省肿瘤医院内科,湖南长沙410013

出　　处：《中华肿瘤防治杂志》2013年第23期1841-1844,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：湖南省科技厅科技计划(2010SK3088)

摘　　要：目的：探讨伊立替康（CPT-11）联合氟尿嘧啶（5FU）及亚叶酸钙（LV）组成的IFL方案时辰化疗治疗晚期结直肠癌的疗效和毒副作用，与常规FOLFIRI方案化疗进行比较。方法：2009—04—01—2012—05—30中南大学湘雅医学院附属肿瘤医院83例晚期结直肠癌复治患者分别采用IFL方案时辰化疗和FOLFIRI方案常规化疗。时辰组（42例）采用Melodie多通道编程输液泵，CPT-11160mg／m2，d1，2：00--8：00持续静脉滴入，高峰为凌晨5：00；5-FU600mg／（m2·d），d2～d5，22：00～10：00持续静脉滴入，高峰为凌晨4：00；LV200mg／（m2·d），d2～d5，用法同5-Fu。常规组（41例）白天给药：CPT-11160mg／m2静脉滴入，d1；LV200mg／（m2·d），静脉滴入2h，d1～d2；5-FU400mg／（m2·d）静脉推注，d1～d2；5-FU600mg／（m2·d），持续静脉滴入22h，d1～d2。结果：时辰化疗方案和FOLFIRI方案的总有效率（RR）分别为26．2％和71．4％，疾病控制率（DCR）分别为19．5％和63．4％；时辰化疗方案的中位无进展生存（PFS）为4．9个月，中位总生存时间（OS）为9．3个月；FOLFIRI方案的PFS为4．1个月，OS为8．6个月，两组比较差异均无统计学意义，P〉0．05。两方案常见的毒副作用为恶心呕吐、中性粒细胞减少和脱发，但多以1～2级为主；3～4级毒副作用在时辰化疗方案中的发生率低于FOLFIRI方案，P〈0．05。结论：IFL方案时辰化疗毒副作用发生率较低，患者耐受性较好，可作为晚期结直肠癌患者的二线治疗选择方案。OBJECTIVE：To evaluate the efficacy and toxicity of irinotecanin （CPT-11） combinated with fluorouracil （5-FU） and calcium folinate（LV）（IFL regimen） chronochemotherapy in the treatment of patients with advanced colorectal cancer compared with routine FOLFIRI regimen. METHODS： Totally 83 cases of retreat advanced colorectal cancer patients received IFL regimen chronochemotherapy and FOLFIRI regimen routine chemotherapy respectively. In the chrono- chemotherapy group,Melodie pump was used, CPT-11 160 mg/m2 ,dl , from 2：00 to 8.. 00 at peak time 5AM, 5-FU 600 mg/（m2 · d）,d2--ds ,from 22：00 to 10：00 at peak time 4AM,LV 200 mg/（m2 · d）,d2--d5 ,the usage was the same as 5-FU. In the routine chemotherapy group,the drug were given conventionally as CPT-11 160 mg/m2 ,d1 , LV 200 mg/（m2 · d）, before 5-FU,dl --d2,5-FU 400 mg/（m2 · d） ,iv. ,d1 --d2 followed by 5-FU 600 mg/（ms · d） ,continued iv. drip 22 h,d1- d2. RESULTS：The response rate and disease control rate in chronochemotherapy group were 26.2% and 71.4% ,whereas in FOLFIRI group were 19.5% and 63.4% respectively. The progression free survival （PFS） and the median overall survival time （OS） were 4.9 and 9.3 months in chronochemotherapy group,whereas in FOLFIRI group were 4.1 months and 8.6 months. There were no obvious differences between the two groups （P〈0.05）. The frequent side-effects in the two groups were nausea,vomiting,neutropenia and alopecia, but most of them were slight（grade Ⅰ- Ⅱ ）. While in grade Ⅲ -- Ⅳ side effects, the rate of chronochemotherapy group was lower than that in FOLFIRI group （P〈0.05）. CONCLUSIONS： The IFL regimen chronochemotherapy have low side effects. It is effective and well tolerated in the treatment of advanced colorectal cancer patients. We suggested that it can be used as second line therapy for advanced colorectal cancer.

关 键 词：结直肠肿瘤 药物疗法 时辰化疗 伊立替康 疗效 毒性 

分 类 号：R735.3[医药卫生—肿瘤]