伊立替康联合雷替曲塞治疗晚期结直肠癌临床观察.docVIP

伊立替康联合雷替曲塞治疗晚期结直肠癌的临床观察 　　[摘要] 目的 观察伊立替康联合雷替曲塞方案治疗晚期结直肠癌的有效性和安全性。 方法 收集28例一线化疗方案治疗失败或缓解后再进展的晚期结直肠腺癌患者，行伊立替康联合雷替曲塞化疗，方案：伊立替康150～180mg/m2，静脉滴注，第一天；雷替曲塞3mg/m2静脉滴注，第一天；21d为1个周期，21d后再重复给药，每2～3个周期后评价疗效，治疗期间评估不良反应。 结果 所有患者均可评价疗效，其中PR 2例，SD 19例，PD 7例，无CR者，ORR为7.14%，DCR为75%。中位PFS 6个月，中位OS不小于11.5个月。最常见的毒副反应是中性粒细胞减少和腹泻。 结论 雷替曲塞联合伊立替康方案有效率高，毒副反应小，可以作为晚期结直肠癌的二线治疗方案。 　　[关键词] 晚期结直肠癌；雷替曲塞；伊立替康；二线化疗 　　[中图分类号] R735.3 [文献标识码] A [文章编号] 2095-0616（2015）18-12-04 　　[Abstract] Objective To observe the efficacy and toxicity of irinotecan plus raltitrexed as second-line chemotherapy for advanced colorectal cancer. Methods Twenty-eight patients with advanced colorectal cancer who failed to first-line chemotherapy.The doses of drugs were as follows，CPT-11 150-180mg/m2 ivgtt on day 1 and raltitrexed 3mg/m2 on day 1.One cycle lasted 21 days.After every two or three cycles，therapeutic efficacy was evaluated.The efficacy，side effects，and safety of the treatment were observed. Results All patients successfully completed the the treatment plan. There was 0 case of complete recovery， 2 partial recovery， 19 stable disease，and 7 progressive disease.The overall response rate was 7.14%，the disease control rate was 75%.The mean progression free survival was 6 months，and the mean overall survival was no less than 11.5 months.The most common side effects were neutropenia and diarrhea. Conclusion Irinotecan plus raltitrexed as second-line chemotherapy for advanced colorectal cancer has a high efficacy with acceptable tolerability，and is a therapy worth considering for advanced colorectal cancer. 　　[Key words] Advanced colorectal cancer；Irinotecan；Raltitrexed；Second-line chemotherapy 　　在全球范围内，结直肠癌发病率居男性恶性肿瘤第三位，女性恶性肿瘤第二位[1]。2012年估计有1 460 600例新发病例，693 900例患者死于结直肠癌。氟尿嘧啶（5-FU）一直是晚期/转移性结直肠癌（mCRC）有效的化疗药物，近年来，新的细胞毒药物以及分子靶向药物的发展显著改善了mCRC患者的生存。我科对收治的28例一线行FOLFOX或XELOX方案化疗，出现复发、转移后的结直肠癌患者应用伊立替康联合雷替曲塞方案治疗，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择2011年1月～2014年12月我院接受过一线化疗方案（FOLFOX、XELOX）治疗失败或缓解后再进展的mCRC患者共28例；组织学证实为结直肠腺癌