周剂量CPT-11/LD-FP持续灌注治疗晚期大肠癌的临床研究

Clinical study of weekly irinotecan combined with low dose FP in patients with metastatic colorectal cancer

关键词:  晚期大肠癌/药物治疗  伊立替康  氟脲嘧啶  顺铂

Key words:  colorectal neoplasmas/chemotherapy  Irinotecan  5-fluorouracil  Cisplatin

摘要:

［目的］回顾性分析周剂量伊立替康（irinotecan，CPT-11）联合低剂量5-氟尿嘧啶、顺铂、亚叶酸（LD-FP）持续灌注治疗21例晚期复治大肠癌的近期疗效、生存期和不良反应。［方法］CPT-11 60 mg/m²静脉滴注，第1、8、15天；5-氟尿嘧啶（fluorouracil，5-FU）300 mg/m²/d，第1~14天，采用微量泵持续静脉给药；顺铂（cisplatin，DDP）5 mg/d静脉滴注， 第1~5天，第8~14天；亚叶酸（folinic Acid，CF）100 mg·m^2-1·d^-1静脉滴注，第1~14天，28 d为1周期，2周期化疗结束后评价效。［结果］总有效率（overall response rate, ORR）20.0%，临床获益率75.0%，中位疾病进展期(median time to progression,mTTP)为5个月，中位生存期（median overall survival, MST）为15个月。主要毒性为胆碱能症状、黏膜炎、迟发性腹泻和粒细胞减少。胆碱能症状及黏膜炎均表现轻微，III-IV度中性粒细胞减少发生率为14.3%。III度迟发性腹泻发生率9.5%。［结论］伊立替康采用每周剂量给药的方式联合LD-FP持续灌注治疗晚期大肠癌有一定疗效、毒副作用无增加，可以改善患者生存质量。

Abstract:

［Objective］To evaluate the efficacy and toxicity of weekly Irinotecan combined with low dose FP in patients with metastatic colorectal cancer. ［Methods］From February 2002 to May 2006, 21 previous treatment patients with metastatic colorectal cancer were entered into the study, and their documents were through retrospective analysis. All patients received irinotecan 60 mg·m² iv, d 1, 8, 15; 5-FU 300 mg·m^2-1·d^-1, was administered by continuous infusion for 14 days and CF 100 mg·m^2-1·d^-1, iv, d 1-14, Cisplatin 5 mg/d, iv, d 1-5, d 8-14. Every 4 weeks repeated. \[Results\] In 20 evaluable patients, 4 cases had partial response and 11 cases had stable disease and 5 cases with progressive disease.The overall response rate was 20.0%,mTTP was 5 months. MST was 15 months. The rate of benefit was 75.0% .The main side effect included acute cholinergic syndrome , late-onset diarrhea ,neutropenia and mucitis. Acute cholinergic syndromemain and mucitis expressed mild. The ratios of III /IV neutropenia were 14.3% .The ratios of late-onset diarrhea that expressed grade III were 9.5%. \[ Conclusions\] Irinotecan /low dose FP was active in metastatic colorectal cancer .Toxicity no increase .