伊立替康联合5-氟尿嘧啶/亚叶酸钙双周方案治疗晚期结直肠癌的临床观察

目的:观察伊立替康(CPT-11)联合5-氟尿嘧啶(5-Fu)/亚叶酸钙(LV)方案治疗晚期结直肠癌的疗效及毒副反应。方法:全组31例,可评价疗效者30例,全部采用双周方案:CPT-11180mg·m-2静脉滴注,第1天;LV200mg·m-2静脉滴注,第1、2天;5-Fu400mg·m-2静脉推注,随后5-Fu600mg·m-2静脉滴注22h,第1、2天。14d为1个周期,3个周期(6周)评价疗效。结果:完全缓解1例,部分缓解11例,缓解率达40%;疾病稳定14例,疾病进展4例。中位疾病进展时间为6.5个月,中位生存期为13.9个月。主要毒副反应为迟发性腹泻(Ⅲ/Ⅳ度发生率为30%)及中性粒细胞减少(Ⅲ/Ⅳ度发生率为26.6%)。结论:CPT-11联合5-Fu/LV方案治疗晚期结直肠癌有效率高,毒副反应可以耐受,可作为晚期结直肠癌的一线或二线化疗方案。

Clinical Efficacy of CPT-11 Combined with 5-Fu/LV Regimen for Advanced Colorectal Cancer

OBJECTIVE： To observe the clinical efficacy and toxic effects of irinotecan （CPT-11） combined with 5-fluorouracil/leucovorin （5-Fu/LV） in the treatment of advanced colorectal cancer. METHODS： Among 31 cases of advanced colorectal cancer, 30 cases were evaluable. All patients received 2 weeks of therapy regimen： CPT-11 180 mg·m^-2 i.v. gtt d1, LV 200 mg·m^-2 i.v. gtt d1～2, 5-Fu 400 mg·m^-2 i.v. and 5-Fu 600 mg·m^-2 i.v. gtt for 22 h, d1～2. A treatment course last for 14 days. 6 weeks later, clinical efficacy was evaluated. RESULTS： Complete remission was observed in 1 case and partial remission 11 cases. The remission rate （RR） was 40%. Stable disease was reported in 14 cases and disease progression 4 cases. Medium time to progress （TTP） was 6.5 months and medium survival time（MST） was 13.9 months. Major toxic reactions were delayed diarrhea （Ⅲ/Ⅳ grade of 30%） and neutropenia （Ⅲ/Ⅳ grade of 26.6%）. CONCLUSION： The regimens of CPT-11 combined with 5-Fu / LV have high response rate and tolerable toxicity in treatment of advanced colorectal cancer. It can be use as first or second line chemotherapy for advanced colorectal cancer.