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

发布时间：2018-05-14 06:02

  本文选题：结直肠癌 + 伊立替康　； 参考：《北京协和医学院》2017年硕士论文

【摘要】：目的:观察伊立替康(irinotecan,IRI)和奥沙利铂(oxaliplatin,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有效性和安全性。方法:回顾性分析中国医学科学院肿瘤医院肿瘤内科自2013年3月至2014年10月有可测量指标的晚期结直肠癌患者35例,应用IRI130～160mg/m2,第1天;奥沙利铂85～100mg/m2,第2天;亚叶酸钙(CF)200mg/m2,后5-Fu400mg/m2,静脉推注,第1天,5-Fu2400mg/m2持续静滴46小时,第1天;或替吉奥胶囊(根据体表面积确定初始剂量):体表面积1.25m2,40mg/次;体表面积1.25～1.50m2,50mg/次;体表面积1.50m2,60mg/次;或希罗达1000mg/m2/次,每日2次口服,连续服用10天,停药4天,14天为1周期。每3周期评价疗效及相关毒性反应,化疗结束后每3月随访1次。结果:全组35例患者均可评价疗效,无失访病例。中位化疗周期为4个(3-11)。有效率(objective response rate,ORR)54.3%(19/35),其中完全缓解(complete response,CR)1例,部分缓解(partial response,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%,20/35),其中18例患者系初始局部晚期,2例患者初始伴肝转移。中位无进展生存期为23.9个月[95%CI(10.2,37.7),中位总生存时间30.7月。Ⅲ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%(14/35)。Ⅳ级不良反应发生率为17.1%(6/35),主要为粒细胞下降。未出现治疗相关死亡。结论:调整后的三药联合方案一线治疗晚期结直肠癌疗效好,毒性反应可以耐受,是优先选择方案之一。
[Abstract]:Objective: to observe the efficacy and safety of irinotecan Iritikam (IRI) and oxaliplatin (OXA) combined with fluorouracil (5-FU / tiguo capsule / capecitabine) in the treatment of advanced colorectal cancer. Methods: a retrospective analysis of 35 patients with advanced colorectal cancer with measurable indexes from March 2013 to October 2014 was performed in Oncology Department, Cancer Hospital of the Chinese Academy of Medical Sciences. The patients were treated with IRI 130 ~ 160 mg / m ~ (2), day 1, oxaliplatin 85 ~ 100 mg / m ~ (2), day 2, respectively. Calcium folate (CFT) 200 mg / m2, 5-Fu400 mg / m2, intravenous injection, day 1 continuous intravenous drip of 5-Fu2400 mg / m2 for 46 hours, day 1; or Tigeo capsule (initial dose: 1.25m240mg / time based on body surface area: 1.25m240mg / time; body surface area 1.25m250m2m2mg / time; body surface area 1.50m260mg / time; or Xeloda 1000mg/m2/ time) Take orally twice daily, take continuously for 10 days, stop 4 days for 14 days is 1 cycle. Efficacy and related toxic reactions were evaluated every 3 cycles, followed up every 3 months after chemotherapy. Results: 35 patients in the whole group can evaluate the curative effect. The median period of chemotherapy was 3-11. The effective rate was 54.3 / 35, including 1 case of complete remission of complete response and 18 cases of partial response. Of the 25 patients who underwent surgery after chemotherapy, 20 patients had R0 resection and 57.1% of 35 / 35 patients, of whom 18 patients were initially locally advanced and 2 patients had initial liver metastasis. The median progression-free survival time was 23.9 months. The median survival time was 30.7 months, and the median survival time was 30.7 months. The incidence of adverse reactions in grade 鈪，

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