本文選題：結(jié)直腸癌 + 伊立替康　； 參考：《北京協(xié)和醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察伊立替康(irinotecan,IRI)和奧沙利鉑(oxaliplatin,OXA)聯(lián)合氟尿嘧啶類藥物(5-FU/替吉奧膠囊/卡培他濱)一線治療晚期結(jié)直腸癌的有效性和安全性。方法:回顧性分析中國醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院腫瘤內(nèi)科自2013年3月至2014年10月有可測量指標(biāo)的晚期結(jié)直腸癌患者35例,應(yīng)用IRI130～160mg/m2,第1天;奧沙利鉑85～100mg/m2,第2天;亞葉酸鈣(CF)200mg/m2,后5-Fu400mg/m2,靜脈推注,第1天,5-Fu2400mg/m2持續(xù)靜滴46小時(shí),第1天;或替吉奧膠囊(根據(jù)體表面積確定初始劑量):體表面積1.25m2,40mg/次;體表面積1.25～1.50m2,50mg/次;體表面積1.50m2,60mg/次;或希羅達(dá)1000mg/m2/次,每日2次口服,連續(xù)服用10天,停藥4天,14天為1周期。每3周期評價(jià)療效及相關(guān)毒性反應(yīng),化療結(jié)束后每3月隨訪1次。結(jié)果:全組35例患者均可評價(jià)療效,無失訪病例。中位化療周期為4個(gè)(3-11)。有效率(objective response rate,ORR)54.3%(19/35),其中完全緩解(complete response,CR)1例,部分緩解(partial response,PR)18例�；熀蠼邮苁中g(shù)的25例患者中,20例患者達(dá)到R0切除(57.1%,20/35),其中18例患者系初始局部晚期,2例患者初始伴肝轉(zhuǎn)移。中位無進(jìn)展生存期為23.9個(gè)月[95%CI(10.2,37.7),中位總生存時(shí)間30.7月。Ⅲ級不良反應(yīng)發(fā)生率為54.3%(19/35),其中粒細(xì)胞下降發(fā)生率為20.0%(7/35),惡心發(fā)生率為17.1%(6/35),嘔吐發(fā)生率為14.3%(5/35),腹瀉發(fā)生率40%(14/35)。Ⅳ級不良反應(yīng)發(fā)生率為17.1%(6/35),主要為粒細(xì)胞下降。未出現(xiàn)治療相關(guān)死亡。結(jié)論:調(diào)整后的三藥聯(lián)合方案一線治療晚期結(jié)直腸癌療效好,毒性反應(yīng)可以耐受,是優(yōu)先選擇方案之一。
[Abstract]:Objective: to observe the efficacy and safety of irinotecan Iritikam (IRI) and oxaliplatin (OXA) combined with fluorouracil (5-FU / tiguo capsule / capecitabine) in the treatment of advanced colorectal cancer. Methods: a retrospective analysis of 35 patients with advanced colorectal cancer with measurable indexes from March 2013 to October 2014 was performed in Oncology Department, Cancer Hospital of the Chinese Academy of Medical Sciences. The patients were treated with IRI 130 ~ 160 mg / m ~ (2), day 1, oxaliplatin 85 ~ 100 mg / m ~ (2), day 2, respectively. Calcium folate (CFT) 200 mg / m2, 5-Fu400 mg / m2, intravenous injection, day 1 continuous intravenous drip of 5-Fu2400 mg / m2 for 46 hours, day 1; or Tigeo capsule (initial dose: 1.25m240mg / time based on body surface area: 1.25m240mg / time; body surface area 1.25m250m2m2mg / time; body surface area 1.50m260mg / time; or Xeloda 1000mg/m2/ time) Take orally twice daily, take continuously for 10 days, stop 4 days for 14 days is 1 cycle. Efficacy and related toxic reactions were evaluated every 3 cycles, followed up every 3 months after chemotherapy. Results: 35 patients in the whole group can evaluate the curative effect. The median period of chemotherapy was 3-11. The effective rate was 54.3 / 35, including 1 case of complete remission of complete response and 18 cases of partial response. Of the 25 patients who underwent surgery after chemotherapy, 20 patients had R0 resection and 57.1% of 35 / 35 patients, of whom 18 patients were initially locally advanced and 2 patients had initial liver metastasis. The median progression-free survival time was 23.9 months. The median survival time was 30.7 months, and the median survival time was 30.7 months. The incidence of adverse reactions in grade 鈪，

本文編號：1886634