戴月娣,张德祥,谭越,郭伟剑

• 1:复旦大学附属肿瘤医院闵行分院肿瘤内科
• 2:复旦大学附属中山医院普外科
• 3:复旦大学附属肿瘤医院肿瘤内科

摘要(Abstract)：

目的观察伊立替康联合替吉奥(IRIS)方案二线及三线治疗晚期结直肠癌(colorectal cancer,CRC)的近期疗效和安全性。方法一线及二线方案治疗失败的晚期CRC患者接受IRIS方案治疗:伊立替康180 mg/m2,d1,联合替吉奥2周或3周重复;替吉奥:体表面积(body surface area,BSA)<1.25 m2时40 mg,BSA≥1.25 m2、≤1.50 m2时50 mg,BSA>1.50 m2时60 mg,每天2次口服,d1-7,2周重复,或d1-14,3周重复;2周方案治疗每4周期评价疗效,3周方案每2周期评价疗效;治疗每周期评价不良反应。结果共51例可评价患者,治疗后疗效达完全缓解0例(0%)、部分缓解22例(43.1%)、稳定17例(33.3%)、进展12例(23.5%),临床获益率76.5%。中位无进展生存时间(progress free survival,PFS)5.0(95%CI:3.7-6.3)月。单因素Cox回归模型分析显示,二线、三线IRIS方案治疗后疗效对PFS有影响(HR:1.91,95%CI:1.27-2.87,P=0.002);多因素Cox回归模型分析显示,肿瘤低分化的患者较中分化患者PFS有延长(HR:0.14,95%CI:0.05-0.43,P=0.001),治疗疗效对PFS有影响(HR:2.80,95%CI:1.63-4.83,P=0.000),PS评分为0分的患者较1分者PFS有延长趋势(HR:2.93,95%CI:0.98-8.76,P=0.054)。≥3度不良反应为粒细胞减少及消化道反应。结论 IRIS方案二线及三线治疗晚期CRC临床获益率高,总体安全性较好。

关键词(KeyWords)： 结直肠肿瘤/药物疗法;喜树碱/类似物和衍生物;喜树碱/治疗应用;氟尿嘧啶/类似物和衍生物;氟尿嘧啶/投药和剂量;药物疗法,联合;治疗结果

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 戴月娣,张德祥,谭越,郭伟剑

DOI: 10.13267/j.cnki.syzlzz.2014.02.024

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