雷替曲塞联合伊立替康治疗晚期大肠癌疗效观察(1)
[摘要] 目的 探讨雷替曲塞联合伊立替康二线治疗大肠癌的疗效及安全性评价。 方法 选择2011年6月～2014年12月间的78例经FOLFOX方案一线化疗失败的复发性或转移性大肠癌患者，随机分为FOLFIRI组和雷替曲塞联合伊立替康组。FOLFIRI组38例，予FOLFIRI方案化疗；雷替曲塞联合伊立替康组40例，予雷替曲塞联合伊立替康化疗。两组均至少治疗2个周期，观察疗效、不良反应，并随访观察中位无疾病进展生存期(MPFS)、1年生存率。结果 雷替曲塞联合伊立替康组的有效率42.50%，明显高于FOLFIRI组(13.16%)，差异具有统计学意义(P<0.05)；雷替曲塞联合伊立替康组的MPFS为6个月，高于FOLFIRI组3个月，差异无统计学意义(P>0.05)；两组胃肠道不适、粒细胞减少、腹泻等不良反应差异无统计学意义(P>0.05)。 结论 雷替曲塞联合伊立替康二线治疗晚期大肠癌疗效肯定，安全性好，值得临床推广。
[关键词] 伊立替康；雷替曲塞；晚期大肠癌；二线治疗
[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701(2015)34-0071-03
Effect of irinotecan combined with raltitrexed as second-line chemotherapy in the treatment of advanced colorectal cancer
LIU Jun WEN Fugang LI Bin
Eight Ward， Department of Medical Oncology， Anshan Tumor Hospital in Liaoning Province， Anshan 114031， China
[Abstract] Objective To evaluate the efficacy and toxicity of irinotecan combined with raltitrexed as second-line chemotherapy in the treatment of advanced colorectal cancer. Methods A total of 78 patients with advanced colorectal cancer who had received FOLFOX first-line therapy but had relapsed or progressed from June 2011 to December 2014 were selected. All patients were randomly divided into FOLFIRI group (n=38) and irinotecan combined with raltitrexed group(n=40). The patients in FOLFIRI group were treated with FOLFIRI chemotherapy， and the patients in irinotecan combined with raltitrexed group were given irinotecan and raltitrexed. All patients were given two cycles of chemotherapy at least. Then the efficacy， toxicity， median progression-free survival (MPFS) and one year survival rate were evaluated. Results The effective rate in irinotecan combined with raltitrexed group was 42.50%， significantly higher than that of 13.16% in the FOLFIRI group， and the difference was statistically significant(P<0.05). The MPFS in irinotecan combined with raltitrexed group were 6 months， significantly higher than that 3 months in the FOLFIRI group， but the difference had no statistically significant (P>0.05). The toxicities included gastrointestinal reaction， neutropenia and diarrhea had no significant difference between two groups(P>0.05). Conclusion Irinotecan combine with raltitrexed as second-line chemotherapy in treatment of advanced colorectal cancer is effective and well tolerance.
[Key words] Irinotecan； Raltitrexed； Advanced colorectal cancer； Second-line chemotherapy
大肠癌是常见的消化道恶性肿瘤之一，起源于大肠黏膜上皮的恶性肿瘤，其发病率呈上升趋势[1]。大肠癌对化疗的敏感性相对较高，仍然是晚期大肠癌的主要治疗手段。长期以来，以5-氟尿嘧啶(5-FU)为基础的联合化疗方案如FOLFOX或FOLFIRI是晚期大肠癌的一线化疗方案，治疗有效率<60%[2，3]。对于一线化疗失败的患者，目前尚缺乏标准的化疗方案。雷替曲塞为一种新型抗肿瘤药物，其作用机制为直接抑制胸苷酸合成酶，较氟尿嘧啶类有更好的疗效和相对较少的不良反应。本研究用FOLFIRI治疗方案为对照，研究雷替曲塞联合伊立替康(CPT-11)二线治疗晚期大肠癌的疗效及安全性，现报道如下。, 百拇医药(刘君 温福刚 李彬)
[关键词] 伊立替康；雷替曲塞；晚期大肠癌；二线治疗
[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701(2015)34-0071-03
Effect of irinotecan combined with raltitrexed as second-line chemotherapy in the treatment of advanced colorectal cancer
LIU Jun WEN Fugang LI Bin
Eight Ward， Department of Medical Oncology， Anshan Tumor Hospital in Liaoning Province， Anshan 114031， China
[Abstract] Objective To evaluate the efficacy and toxicity of irinotecan combined with raltitrexed as second-line chemotherapy in the treatment of advanced colorectal cancer. Methods A total of 78 patients with advanced colorectal cancer who had received FOLFOX first-line therapy but had relapsed or progressed from June 2011 to December 2014 were selected. All patients were randomly divided into FOLFIRI group (n=38) and irinotecan combined with raltitrexed group(n=40). The patients in FOLFIRI group were treated with FOLFIRI chemotherapy， and the patients in irinotecan combined with raltitrexed group were given irinotecan and raltitrexed. All patients were given two cycles of chemotherapy at least. Then the efficacy， toxicity， median progression-free survival (MPFS) and one year survival rate were evaluated. Results The effective rate in irinotecan combined with raltitrexed group was 42.50%， significantly higher than that of 13.16% in the FOLFIRI group， and the difference was statistically significant(P<0.05). The MPFS in irinotecan combined with raltitrexed group were 6 months， significantly higher than that 3 months in the FOLFIRI group， but the difference had no statistically significant (P>0.05). The toxicities included gastrointestinal reaction， neutropenia and diarrhea had no significant difference between two groups(P>0.05). Conclusion Irinotecan combine with raltitrexed as second-line chemotherapy in treatment of advanced colorectal cancer is effective and well tolerance.
[Key words] Irinotecan； Raltitrexed； Advanced colorectal cancer； Second-line chemotherapy
大肠癌是常见的消化道恶性肿瘤之一，起源于大肠黏膜上皮的恶性肿瘤，其发病率呈上升趋势[1]。大肠癌对化疗的敏感性相对较高，仍然是晚期大肠癌的主要治疗手段。长期以来，以5-氟尿嘧啶(5-FU)为基础的联合化疗方案如FOLFOX或FOLFIRI是晚期大肠癌的一线化疗方案，治疗有效率<60%[2，3]。对于一线化疗失败的患者，目前尚缺乏标准的化疗方案。雷替曲塞为一种新型抗肿瘤药物，其作用机制为直接抑制胸苷酸合成酶，较氟尿嘧啶类有更好的疗效和相对较少的不良反应。本研究用FOLFIRI治疗方案为对照，研究雷替曲塞联合伊立替康(CPT-11)二线治疗晚期大肠癌的疗效及安全性，现报道如下。, 百拇医药(刘君 温福刚 李彬)