Clinical observation on irinotecan as second-line treatment of patients with advanced colorectal carcinoma
- VernacularTitle:伊立替康二线治疗晚期结直肠癌疗效观察
- Author:
Donghui CHEN
;
Weifeng SONG
;
Liwei WANG
- Publication Type:Journal Article
- Keywords:
colorectal cancer;
chemotherapy;
irinotecan;
5-FU;
LV
- From:
China Oncology
2006;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Background and purpose:Colorectal carcinoma(CRC) is a major cause of cancer-related mortality. In the 1990s, several fi rst-line phase Ⅲ trails showed a signifi cant improvement in result with the addition of CPT-11(irinotecan, which is a specifi c inhibitor of topoisomerase Ⅰ) to FU-LV combination therapy(FOLFIRI).We observed the survival rate, effi cacy and adverse reaction of the combination chemotherapy of irinotecan plus folinic acid/continuous 5-? uorouracil bimonthly FOLFIRI regimen as second chemotherapy in treating advanced colorectal adenocarcinoma. Methods:Sixty patients with histologically proved advanced colorectal adenocarcinoma whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics agents were included to receive at least 2 cycles of chemotherapy with irinotecan 180 mg/m2 day 1 and folinic acid 200 mg/m2 iv,5-FU 400 mg/m2 iv bolus,days 1 and 2, 5-FU 600 mg/m2 iv infusion over 22 hours, days 1 and 2.Treatment was repeated every two weeks. Results:All patients were assessable for toxicity and 58 patients were evaluable for treatment response. The non-hematological toxicity was mild. Most was grade Ⅰ or Ⅱ. Only two patients experienced grade Ⅲ diarrhea and one patient experienced grade Ⅲ nausea and vomiting. There were no cases with grade Ⅳ toxicity. The most common hematological toxicity was neutropenia. Grade Ⅲ neutropenia were observed in fi ve patients. There was no case of febrile neutropenia. Based on intention to treat analysis, there were no complete responses (CR), 14(24.14%) partial response (PR), and 30 (51.72%) stable disease. the median time to disease progression was 6.09 months. The median overall survival was 9.65 months. Conclusions:Bimonthly irinotecan in combination with folinic acid and 5-fluorouracil was active with acceptable toxicities and a prolonged survival time in retreated colorectal cancer.
