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目的观察和评价依立替康(CPT-11)联合5-FU/LV治疗FOLFOX治疗失败的转移性结直肠癌的疗效及不良反应。方法入组患者共34例为转移性结直肠癌,经草酸铂及5-FU/LV治疗失败后,予CPT-11 60mg/m2,LV100mg/m2,5-FU 500mg/m2,每周1次,连续3周,每4周重复。患者最多接受6个周期,每例至少2周期化疗后评价疗效。结果全组34病例均可评价。PR为5例,SD为17例,有效率14.7%(95%可信区间3.6%～34.4%),疾病控制率64.7%(95%可信区间46.8%～85.6%),平均TTP为3.5个月(范围1.5～7.5个月)。主要不良反应为白细胞减少,恶心呕吐,手足综合征及延迟性腹泻,其不良反应发生率分别为67.4%(23/34),61.8%(21/34),64.8%(22/34),38.2%(13/34),均无IV度不良反应。结论周剂量伊立替康联合5-FU/LV为草酸铂治疗失败的转移性结直肠癌挽救治疗方案,不良反应轻微,适合于曾经强烈化疗患者。
Objective To observe and evaluate the efficacy and adverse effects of irinotecan (CPT-11) combined with 5-FU / LV in the treatment of metastatic colorectal cancer with FOLFOX failure. Methods A total of 34 patients with metastatic colorectal cancer were treated with oxaliplatin and 5-FU / LV after CPT-11 60mg / m2, LV100mg / m2, and 5-FU 500mg / m2 once a week , For 3 consecutive weeks, repeated every 4 weeks. Patients receive up to 6 cycles, with at least 2 cycles of chemotherapy evaluated in each case. Results The whole group of 34 cases can be evaluated. PR was 5 and SD was 17, the effective rate was 14.7% (95% confidence interval 3.6% -34.4%), disease control rate was 64.7% (95% confidence interval 46.8% -85.6%), and the average TTP was 3.5 Month (range 1.5 to 7.5 months). The main adverse reactions were leukopenia, nausea and vomiting, hand-foot syndrome and delayed diarrhea. The incidences of adverse reactions were 67.4% (23/34), 61.8% (21/34), 64.8% (22/34), 38.2 % (13/34), no adverse effects of IV. Conclusions Weekly dose of irinotecan combined with 5-FU / LV is a salvage therapy for metastatic colorectal cancer that failed to be treated with oxaliplatin. The adverse reactions were mild and suitable for patients who had intensive chemotherapy.