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目的:观察伊立替康(CPT-11)与卡培他滨联合一线治疗晚期结直肠癌的疗效和不良反应。方法:46例晚期结直肠癌病人采用CPT-11+卡培他滨方案治疗即CPT-11250mg·m~(-2)静脉滴注2h,d1给药,21d为一个周期,同时给予卡培他滨1250mg·m~(-2),每日分2次口服,于d1～14用药,21d为—个周期。每例治疗2个周期后进行临床疗效和不良反应评价。结果:可评价疗效40例,完全缓解(CR) 2例,部分缓解(PR)19例,稳定(SD)17例,进展(PD)2例,总有效率(CR+PR)为52％,在11例发生肺转移的病人中PR4例,有效率为36％。全组中位肿瘤进展时间(TFP)为9.6mo,中位生存期20.8mo。全组共完成170个化疗周期其主要不良反应为迟发性腹泻69个周期,占40.6％,其中Ⅲ-Ⅳ度腹泻23个周期,占13.5％;化疗后中性粒细胞减少90个周期,占52.9％,其中Ⅲ-Ⅳ度中性粒细胞减少35个周期,占20.6％和手足综合征1.2％。结论:CPT-11与卡培他滨联合一线治疗晚期结直肠癌是有效的。其主要不良反应是腹泻、中性粒细胞下降和手足综合征。
Objective: To observe the efficacy and adverse reactions of irinotecan (CPT-11) combined with capecitabine in the first-line treatment of advanced colorectal cancer. Methods: Forty-six patients with advanced colorectal cancer were treated with CPT-11 + capecitabine for 2 hours after CPT-11250mg · m -2 infusion. One day after 21 days, Bin 1250mg · m ~ (-2), 2 times a day orally, d1 ~ 14 medication, 21d for a cycle. The clinical efficacy and adverse reactions were evaluated after 2 cycles of treatment. Results: There were 40 patients with CR (complete remission), 19 with partial remission (PR), 17 with stable (SD) and 2 with progress (PD). The total effective rate (CR + PR) In 11 cases of lung metastases in PR4 cases, the effective rate was 36%. The median time to tumor progression (TFP) was 9.6 months and the median survival time was 20.8 months. The group completed a total of 170 cycles of chemotherapy, the main adverse reactions were delayed diarrhea, 69 cycles, accounting for 40.6%, of which Ⅲ-Ⅳ degrees of diarrhea 23 cycles, accounting for 13.5%; chemotherapy neutropenia 90 cycles, Accounting for 52.9%, in which Ⅲ-Ⅳ neutropenia 35 cycles, accounting for 20.6% and hand-foot syndrome 1.2%. Conclusion: CPT-11 and capecitabine combined with first-line treatment of advanced colorectal cancer is effective. The main adverse reactions are diarrhea, neutropenia and hand-foot syndrome.