伊立替康联合顺铂二线治疗晚期胃癌的临床观察
Second-line Chemotherapy with Irinotecan Plus Cisplatin for Patients with Advanced Gastric Cancer
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摘要: 目的 评估伊立替康(CPT-11)联合顺铂(DDP) (IC方案)二线治疗晚期胃癌的疗效和安全性。方法以一线方案不含伊立替康和顺铂化疗失败的晚期胃腺癌患者36例为研究对象,采用IC方案治疗,具体为：CPT-11 250 mg/m2,DDP 75 mg/m2第1天静脉输注,每3周重复。观察患者的疗效和不良反应。结果可供评价的35例患者,共接受了117周期的化疗,其中CR 2例,PR 7例,SD 10例,PD 16例,有效率RR为25.7%(9/35),疾病控制率DCR为54.3%(19/35)。中位TTP为4.6月(3.2～6.5月)。最常见的不良反应为白细胞减少(77.1%)、中性粒细胞减少(74.3%)、恶心呕吐(57.1%)、腹泻(28.6%),其3~4度发生率分别为28.6%、28.6%、31.4%、20.0%,总体耐受性良好。结论IC方案可安全有效地应用于一线化疗失败的晚期胃癌患者。Abstract: Objective To evaluate the efficacy and safety of irinotecan combined with cisplatin in patients with advanced gastric cancer after failure of first-line chemotherapy. Methods Totally 36 patients with metastatic gastric cancer were enrolled.Patients received intravenous CPT-11 250 mg/m2 and DDP 75 mg/ m2 on the first day,every 3 weeks. Results Thirty-five patients were evaluable for response.A total of 117 cycles of chemotherapy (average 3.34) were administered.The overall response rate and disease control rate were 25.7% and 54.3%,respectively.The median time to progression were 4.6 months (3.2-6.5 months).All 35 patients were evaluable for safety.The most common adverse events were leukopenia (77.1%),neutropenia (74.3%),nausea and vomiting (57.1%),and diarrhea (28.6%).The occurrence rates of these grade 3-4 events were 28.6%,28.6%,34.1% and 20.0%,respectively.All adverse events were tolerable. Conclusion Irinotecan plus cisplatin is effective and well tolerated in Chinese patients with advanced gastric cancer after failure of first-line chemotherapy.
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