[FORFIRI方案治疗奥沙利铂化疗失败晚期结直肠癌的疗效]。

Yu-Hong Li, Feng-Hua Wang, Dong-Sheng Zhang, Zhi-Qiang Wang, Fen Feng, Li Zhang, Rui-Hua Xu, Wen-Qi Jiang, You-Jian He
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摘要

背景与目的:伊立替康(CPT-11)、奥沙利铂、5-氟尿嘧啶(5-FU)和卡培他滨是治疗晚期结直肠癌的主要药物。对于先前接受奥沙利铂+ 5-FU或卡培他滨治疗的患者,推荐使用FORFIRI方案。本研究旨在探讨FORFIRI方案治疗未接受奥沙利铂为主化疗的晚期结直肠癌的疗效和安全性,并分析临床因素对疗效的影响。方法:90例既往接受FOLFOX6辅助治疗方案的晚期结直肠癌患者,在治疗完成后12个月内出现进展或对既往FOLFOX6/CapeOX方案作为一线治疗无反应,采用FORFIRI方案进行治疗。观察两组患者的疗效及不良反应。结果:81例可评估患者中,2例完全缓解,20例部分缓解,34例病情稳定。总有效率为27.2%,疾病控制率为69.1%。中位进展时间为6.8个月(95% CI, 4.9-8.8个月),中位总生存时间为18.8个月(95% CI, 17.5-20.2个月)。主要不良事件为恶心、呕吐、中性粒细胞减少、脱发、乏力、肝功能受损、口腔黏膜炎、腹泻。III级不良事件包括15例脱发(16.7%)、10例呕吐(11.1%)、8例恶心(8.9%)、5例中性粒细胞减少(5.6%)、2例肝功能受损(2.2%)和2例口腔黏膜炎(2.2%)。结论:FOLFIRI方案对FOLFOX6/CapeOX方案治疗失败的晚期结直肠癌是有效且耐受性良好的补救性治疗,可广泛应用。
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[Efficacy of FORFIRI regimen on oxaliplatin-based chemotherapy-failed advanced colorectal cancer].
BACKGROUND AND OBJECTIVE Irinotecan (CPT-11), oxaliplatin, 5-fluorouracil (5-FU) and capecitabine are main active agents for advanced colorectal cancer. FORFIRI regimen is recommended for the patients who were treated with oxaliplatin plus 5-FU or capecitabine previously. This study was to investigate the efficacy and safety of FORFIRI regimen in treating advanced colorectal cancer failing to prior oxaliplatin-based chemotherapy, and analyze the impacts of clinical factors on the responses. METHODS A total of 90 patients with advanced colorectal adenocarcinoma, who had received prior adjuvant FOLFOX6 regimen and progressed within 12 months after the completion of therapy or had no response to prior FOLFOX6/CapeOX regimen as first-line therapy, were treated with FORFIRI regimen. The efficacy and adverse events were observed. RESULTS Of the 81 evaluable patients, two achieved complete remission, 20 achieved partial remission and 34 had stable disease. The overall response rate was 27.2% and disease control rate was 69.1%. The median time to progression was 6.8 months (95% CI, 4.9-8.8 months) and median overall survival time was 18.8 months (95% CI, 17.5-20.2 months). The main adverse events time were nausea, vomiting, neutropenia, alopecia, fatigue, impaired liver function, oral mucositis and diarrhea. Grade III adverse events included alopecia in 15 patients (16.7%), vomiting in 10 patients (11.1%), nausea in eight patients (8.9%), neutropenia in five patients (5.6%), impaired liver function in two patients (2.2%) and oral mucositis in two patients (2.2%). CONCLUSION FOLFIRI regimen is effective and well-tolerated as salvage therapy for advanced colorectal cancer failing to prior FOLFOX6/CapeOX regimen, and thus can be used widely.
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