含伊立替康方案二线治疗35例晚期食管癌的临床观察  

Clinical observation of irinotecan-based regimens as second-line treatment in 35 cases of advanced esophageal squamous cell carcinoma

作　　者：刘捷[1] 范南峰[1] 李惠[1] 郑亮[1] 

机构地区：[1]福建省肿瘤医院肿瘤内科,福州350014

出　　处：《福建医药杂志》2014年第5期87-90,共4页Fujian Medical Journal

摘　　要：目的观察含伊立替康的联合化疗方案在晚期食管癌二线治疗中的临床疗效及毒性反应。方法 35例既往经紫杉醇联合铂类一线化疗无效或进展的晚期食管癌患者,二线化疗使用伊立替康+顺铂方案20例(伊立替康180mg/m2静滴第1天,顺铂50mg/m2静滴第2天);使用伊立替康+氟尿嘧啶+亚叶酸钙(FOLFIRI)方案15例(伊立替康180mg/m2静滴第1天,氟尿嘧啶2 400mg/m2持续静滴46h,亚叶酸钙400mg/m2静滴第1天),均为双周化疗方案。结果完全缓解(CR)0例,部分缓解(PR)8例,稳定(SD)12例,进展(PD)15例,有效率为22.8%,疾病控制率为57.1%,中位无进展生存期(PFS)2.7个月,中位总生存期(OS)7.3个月。主要毒副反应为血液学毒性及恶心呕吐、腹泻,全组无毒性相关死亡。结论含伊立替康的联合化疗方案作为晚期食管癌的二线治疗方案安全有效,毒副反应可耐受,值得在临床上进一步观察及研究。Objective To evaluate the efficacy and toxicity of irinotecan（CPT-11）as second-line regimens in patients with advanced esophageal squamous cell carcinoma（ESCC）.Methods A total of 35 advanced ESCC patients after failure to chemotherapy with paclitaxel and platinum received Irinotecan-based combination chemotherapy as second-line regimen.Of them,20 cases received IP regimen（irinotecan 180mg/m^2 d1,cisplatin 50mg/m2 d2）,15 cases received FOLFIRI regimen（irinotecan 180mg/m^2 d1,5-FU 2 400mg/m^2 continuous infusion over 46 hours,folinic acid（FA）400mg/m^2 d1）,all repeated every14 days.Results For a total of 35 patients,8patients achieved PR,12 patients achieved SD,15 patients achieved PD.The response rate was 22.8%,and the disease control rate was 57.1%.The median progression-free survival（PFS）and overall survival（OS）was 2.7and 7.3months.The most common adverse events（AEs）were myelosuppression,nausea,vomit and diarrhea.Conclusion Irinotecan-based combination chemotherapy as second-line regimen is effective,safe and well-tolerated in patients with advanced esophageal squamous cell carcinoma.It is valuable for further observation in clinical practice.

关 键 词：伊立替康 二线化疗 晚期食管癌 

分 类 号：R735.1[医药卫生—肿瘤]