【摘要】 目的:观察晚期结直肠癌患者采用伊立替康联合雷替曲塞(IR)方案二线治疗的疗效及安全性。方法:2013年1月至2016年6月46例XELOX或FOLFOX方案一线治疗失败的晚期肠癌患者在我科接受IR方案二线治疗,即:伊立替康180 mg/m290 min静滴d1;雷替曲塞3 mg/m215 min静滴d1;3周为1个周期,每2个周期按照RECIST1.1进行化疗近期疗效评价,采用NCI-CTCEA 4.0评价化疗毒性不良反应,并采用电话随访方式确定生存情况。结果:46例晚期肠癌患者均可纳入评价,总计接受172周期化疗,无患者CR,7例PR,ORR为15.21%,DCR达60.87%;中位PFS 3.2个月(95%CI:2.1~4.2个月),中位OS 8.1个月(95%CI:7.0~9.8个月),1年生存率为23.91%(11/46);常见毒性不良作用有中性粒细胞减少、迟发性腹泻、贫血、恶心呕吐、肝损害、疲乏等,多为1~2级,无化疗相关死亡事件发生。结论:IR方案在晚期肠癌二线治疗中有一定疗效、毒性不良反应可耐受。更多还原

【Abstract】 Objective: To investigate the efficacy and safety of second-line treatment combining Irinotecan and Raltitrexed( IR) in patients with advanced colorectal cancer. Methods: Between January 2013 and June2016,46 patients with advanced colorectal cancer who failed first-line treatment with XELOX or FOLFOX regimen received second-line IR treatment in our department: 90-min intravenous infusion of Irinotecan( 180 mg/m2)and 15-min intravenous infusion of Raltitrexed 3 mg/m2 on day 1. Each cycle consisted of 3 weeks. Once in every2 cycles,the short-term efficacy was evaluated in accordance with RECIST1.1,and the chemotherapy toxicity was evaluated based on NCI-CTCEA 4.0. Phone calls were used to follow up the patient survival.Results: 46 patients with advanced colorectal cancer were included in the evaluation. Afte a total of 172 cycles,there were no patient with CR and 7 with PR. The ORR was 15.21% and DCR was 60.87%. The median PFS was 3.2 months( 95%CI:2.1 ~ 4.2 months). The median OS was 8.1 months( 95%CI: 7.0 ~ 9.8 months) and the 1-year survival rate was23.91%( 11/46). The common toxic effects were neutropenia and delayed diarrhea,anemia,nausea,vomiting,liver damage,and fatigue,mostly of grades 1 to 2. No chemotherapy-related deaths were noted. Conclusion: The IR regimen shows certain therapeutic efficacy as a second-line treatment in advanced colorectal cancer,with tolerable toxic effects.更多还原