伊立替康联合替吉奥改良化疗方案与FOLFIRI治疗晚期结直肠癌的疗效对比观察  

Modified Regimen with Irinotecan and S-1 （Iris） Versus Folfiri in the Treatment Of Metastatic Colorectal Cancer

作　　者：徐敏 朱美琴 白桦 陈亦欣[2] 申维玺 

机构地区：[1]暨南大学第二临床医学院深圳市人民医院肿瘤内科,广东深圳518020 [2]暨南大学第二临床医学院深圳市人民医院深圳市肿瘤研究所,广东深圳518020

出　　处：《医学临床研究》2015年第7期1296-1298,1301,共4页Journal of Clinical Research

摘　　要：【目的】比较改良IRIS方案与经典FOLFIRI方案治疗晚期结直肠癌（mCRC）的近期疗效及其毒副反应。【方法】选择2011年3月至2012年9月本院收治的64例mCRC患者，将其随机分配为观察组（n=32）和对照组（n=32）。观察组接受改良IRIS方案伊立替康（CPT-11）联合滞后2d服用替吉奥（S-1），对照组接受标准FOLFIRI方案，观察两组化疗的毒副反应并评价化疗疗效。【结果】①疗效：两组患者RR、DCR无显著性差异（P〉0．05）。②毒副反应：两组方案最常见为骨髓抑制、厌食、疲劳、恶心呕吐、腹泻等，多为Ⅰ～Ⅱ度，Ⅲ度毒性反应少见，无Ⅳ度不良反应发生。其中对照组Ⅲ度粒细胞减少、恶心呕吐较实验组更严重，差别有统计学意义（P〈0．05）。③生存期：实验组和对照组的无进展生存期为8．2个月和7．9个月，中位生存期为21．8个月和21．4个月，差异均无统计学意义（P〉0．05）。【结论】改良IRIS方案治疗mCRC近期临床疗效较好，毒副反应可以耐受，生存期不亚于采用标准FOLFIRI方案治疗的患者，值得临床推广。[Objective] To evaluate the efficacy and toxicity of modified irinotecan plus S-1 （IRIS） regimen versus classic FOLFIRI in the treatment of distant metastatic colorectal cancer （mCRC）. [Methods] From March 2011 to September 2012, a total of 64 mCRC patients were randomly divided into experimental （modified IRIS, n = 32） and control （FOLFIRI, n ; 32） groups. The experimental group received modified IRIS while the control group standard FOLFIRI. Adverse reaction and chemotherapeutic efficacy were examined. [Results] No significant inter-group difference existed in response rate （RR） or disease control rate （DCR） （ P 〉0.05）. The major toxicities included myelosuppression, anorexia, fatigue, nausea, vomiting and diarrhea, etc. There was no grade 4 toxicity. Grade 3 toxicities of neutrocytopenia and vomiting were more common in control group than experiment group （ P d0.05）. The progression-free and overall survivals showed no significant inter-group difference （ P 〉0. 05）. [Conclusion] The modified IRIS regimen （CPT-11＋S-1） is both safe and efficacious for patients with metastatic colorectal cancer. Progression-free survival and overall survival for IRIS is non-inferior to those for FOLFIRI. Toxic and adverse effects are tolerable and long-term effects deserve further evaluations.

关 键 词：结直肠肿瘤/药物疗法 抗肿瘤药/治疗应用 氟尿嘧啶/治疗应用 氟尿嘧啶/类似物和衍生物 抗肿瘤联合化疗方案 

分 类 号：R735.37[医药卫生—肿瘤]