摘要
目的评价我国晚期结直肠癌伊立替康联合5-Fu/亚叶酸钙（FOLFIRI方案）治疗FOLFOX化疗失败的临床疗效和毒副反应。方法 FOLFIRI方案二线治疗62例晚期结直肠癌。方法 ：伊立替康180 mg/m2,第一天静脉滴注90 min;亚叶酸钙400 mg/m2,第一天滴注2 h;5-Fu 2.6g/m2,亚叶酸钙滴注结束后,立即持续泵入46 h。14 d为一周期,每3周期按RESIST标准评价疗效,所有患者至少接受3周期化疗,最多达12周期。结果 62例患者一共接受346个周期的化疗,所有患者均可评价疗效。部分缓解8例（12.9%）,稳定32例（51.6%）,总有效率为12.9%。无完全缓解病例。进展22例（35.5%）,中位进展时间4.5个月。二线化疗后中位生存时间9.2个月。最常见的不良反应为非血液学毒性,Ⅲ级呕吐反应为6例（9.7%）,Ⅲ~Ⅳ级迟发性腹泻为8例（12.9%）,3例（4.8%）出现Ⅲ级乙酰胆碱能综合征,13例（20.9%）发生Ⅲ~Ⅳ级粒细胞减少,2例（3.2%）伴发热;无化疗相关性死亡病例。结论 FOLFIRI方案二线治疗FOLFOX化疗失败的晚期结直肠癌疗效确切,不良反应轻。
Objective To evaluate the efficacy and toxicity of FOLFIRI regimen as second chemotherapy for advanced colorectal cancer（ACC） patients with FOLFOX failure.Methods Sixty-two patients with pathologically confirmed ACC entered into the study.On day 1,patients were infused irinotecan 180mg/m2 over 90min,leucovorin（CF） 400mg/m2over 2h,which was followed by infusion of 5-fluorouracil 2600mg/m2 for 46h.The cycle was repeated every two weeks.Treatment efficacy was evaluated every three cycles based on the RECIST standard.All patients received at least three cycles of therapy with maximum of twelve cycles.Results The patients received a total of 346 cycles of treatment,and were all evaluable for the efficacy and toxicity.The overall effective rate was 12.9% with partial remission in 8 cases （12.9%） and stable disease in 32 cases（51.6%）.There was no case with complete remission.Progression disease was observed in 22 cases（35.5%） with median progression time of 4.5 months and median survival time of 9.2 months.The main non-hematologic toxicity included grade Ⅲ nausea and vomiting in 6 cases（9.7%）,grade Ⅲ～Ⅳ delayed diarrhea in 11 cases（12.9%） and grade Ⅲ cholinergic syndrome in 3 cases（4.8%）.Hematologic toxicity included grade Ⅲ～Ⅳneutropenia in 13 cases（20.9%）,2 cases（3.2%） of which were accompanied with fever.No treatment-related death occurred.Conclusion FOLFIRI regimen is effective and well tolerated as second-line chemotherapy for ACC patients with FOLFOX failure.
出处
《江苏医药》
CAS
CSCD
北大核心
2011年第1期74-77,共4页
Jiangsu Medical Journal
