伊立替康和奥沙利铂联合氟尿嘧啶类药物一线治疗晚期结直肠癌的临床观察  

The clinical observation of combined chemotherapy of irinotecan,oxaliplatin and fluoropyrimidines medication as first-line treatment in advanced colorectal cancer

作　　者：董秋霞[1] 宋岩[1] 王兴元[1] 王玺[1] 黄镜[1] 

机构地区：[1]中国医学科学院肿瘤医院内科,北京100021

出　　处：《癌症进展》2016年第2期155-158,共4页Oncology Progress

摘　　要：目的观察伊立替康（IRI）和奥沙利铂（OXA）联合氟尿嘧啶类药物（5-FU／替吉奥胶囊／卡培他滨）一线治疗晚期结直肠癌的疗效和不良反应。方法选取有可测量指标的晚期结直肠癌患者35例，第1天应用IRI 130-160mg／m^2静脉滴注，同时予亚叶酸钙（CF）200mg／m^2静脉滴注后5-FU 400mg／m^2静脉推注，之后5-FU 2400mg／m^2持续泵注44h；或替吉奥胶囊每次40~60mg（根据体表面积确定），卡培他滨每次1000mg／m^2，早晚饭后各1次，连续服用10d，停药4d；第2天奥沙利铂85～100mg／m^2静脉滴注；14d为1个周期。每3个周期评价疗效及相关毒性反应。结果全组35例可评价疗效，中位化疗为4个周期（3～11）。客观有效率（ORR）为54-3％（19／35），其中完全缓解（CR）1例，部分缓解（PR）18例。化疗后接受手术的25例患者中，20例患者达到R0切除（57．1％），其中18例患者系初始局部晚期，2例患者初始伴肝转移。所有35例患者在治疗期间，未出现治疗相关性死亡，3级不良反应发生率为54.3％（19／35），其中粒细胞下降发生率为20．0％（7／35），恶心发生率为17．1％（6／35），呕吐发生率为14.3％（5／35），腹泻发生率40．0％（14／35）。4级不良反应主要为粒细胞下降发生率，发生率为17．1％（6／35）。结论三药联合方案一线治疗晚期结直肠癌近期疗效高，毒性反应可以耐受。Objective To evaluate the efficacy and safety of combined chemotherapy of irinotecan （IRI）, oxaliplatin （OXA） and fluoropyrimidines （5-FU/S-1/capecitabine） as first-line treatment in advanced coloreetal cancer. Method A total of 35 cases of advanced measurable colorectal cancer were enrolled, and the following regimen was administered： For day 1, IRI 130-160 mg/m^2, IV, plus leucovorin （CF） 200 mg/m^2, IV, followed by 5-FU 400 mg/m^2 IV bolus, IV, then 5-FU 2400 mg/m^2 continuous infusion for 44 hours： or S-1 40-60 mg （based on body surface area） or capecitabine 1000 mg/m2, bid, PO, for 10 consecutive days, and then discontinue for 4 days; For day 2, oxaliplatin 85-100 mg/m^2, IV, with 14 days as a cycle. The efficacy and safety were assessed every 3 cycles. Result Of the 35 evaluable patients, the median number of chemotherapy cycles was 4 （3-11）. The objective response （ORR） was 54.3% （19/35）. Complete response （CR） was observed in 1 case, with a partial response （PR） in 18 cases. 25 patients underwent surgery, and 20 patients achieved R0 resection （57.1%）, including 18 eases having local advancement and 2 cases with hepatic metastases. No treatment-related death was observed in all the 35 patients. The incidence of grade 3 adverse events was 54.3% （19/35）, including neutropenia （20.0%, 7/35）, nausea （17.1%, 6/35）, vomiting （14.3%, 5/35） and diarrhea （40.0%, 14/35）. The incidence of grade 4 adverse events was 17.1% （6/35）, mainly neutropenia. Conclusion The triple combination therapy as first-line treatment for advanced colorectal cancer was associated with good short-term efficacy and tolerable toxicity.

关 键 词：结直肠癌 伊立替康 奥沙利铂 5氟尿嘧啶 替吉奥 卡培他滨 疗效 

分 类 号：R735.3[医药卫生—肿瘤]