Clinical Observation of Irinotecan Combined with Tegafur or 5-Fluorouracil as Second-Line Chemotherapy for Advanced Gastric Cancer
-
摘要: 目的 比较伊立替康联合替吉奥与伊立替康联合5-氟尿嘧啶二线治疗晚期胃癌的临床疗效及不良反应。方法 77例既往应用含铂方案治疗失败的晚期胃癌患者随机分为两组，A组: 36例患者接受伊立替康联合替吉奥胶囊的化疗方案，B组: 41例患者接受伊立替康联合5-氟尿嘧啶的化疗方案，按照WHO标准评价客观疗效和不良反应。结果 患者经治疗后, A组总有效率为 41.7％, 最主要的不良反应为血液学毒性, 表现为白细胞和血小板降低、贫血及腹泻等, 机体可以耐受这些不良反应。B组总有效率为39.2%, 主要的不良反应为静脉炎、腹泻等。A组和B组中位疾病进展时间（TTP）分别为4.8月和3.1月（P=0.001）。结论 两种联合化疗方案都具有较好的疗效, 相对来说，A组具有中位疾病进展时间长和不良反应相对小的优点, 且住院时间短, 可作为既往应用含铂方案治疗失败的晚期胃癌患者的二线化疗方案之一。Abstract: Objective To compare the clinical efficacy and toxicity of irinotecan combined with Tegafur or 5-fluorouracil in the treatment for advanced rectal cancer patients. Methods Seventy-seven advanced gastric cancer patients, who received failed platiniferous regimen, were randomly divided into two groups, 36 patients in Group A were treated with irinotecan and Tegafur and 41 patients in Group B were treated with irinotecan and 5-fluorouracil. Curative effect and adverse reaction were evaluated according to WHO standard. Results The objective response rates in Group A and B were 41.7% and 39.2% individually. The major adverse reaction in Group A was tolerably hematologic toxicity, including thrombocytopenia leukopenia, anemia, diarrhea, etc. While main side effects in Group B were phlebitis, gastrointestinal reactions, etc. The median time to progression (TTP) in Group A and Group B were 4.8 and 3.1 months(P=0.001), respectively. Conclusion Both of two combined chemotherapy regimens have good curative effect, while Group A has longer TTP, milder adverse reaction and shorter hospitalization time.Irinotecan and tegafur could be a secondline chemotherapy for advanced gastric cancer patients who received failed platiniferous regimen.
-
Key words:
- Irinotecan /
- Tegafur /
- 5-fluorouracil /
- Gastric Cancer /
- Second-line chemotherapy
-
-
[1] Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008[J].CA Cancer J Clin,2008,58 (2):71-96. [2] Kamangar F, Dorse GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the word[J]. J Clin Oncol,2006,24 (14): 21 37-50. [3] Pozzo C,Barone C.Is there an optimal chemotherapy regimen for the treatment of advanced gastric cancer that will provide a platform for the introduction of new biological agents?[J]. Oncologist,2008,13 (7):794- 806. [4] Thuss-Pationce PC,Kretzschmar A,Bichev D,et al.Survival advantage for irinotecan versus best supportive care as secondline chemotherapy in gastric cancer--a randomiseed phase Ⅲstudy of the Arbeitsgemeinschaft Internistische Onkologie(AIO)[J]. Eur J Cancer,2011,47(15):2306-14. [5] Numata M, Oshima T, Amano S,et al. Three cases of advanced gastric cancer successfully treated by combination therapy of biweekly S-1 and docetaxel[J]. Gan To Kagaku Ryoho, 20 11,38(3):443-8. [6] Asaumi Y, Miyanaga T, Ito H,et al. Type 4 advanced gastric cancer responding to histological complete response after neoadjuvant S-1 combined with CDDP therapy-report of a case[J]. Gan To Kagaku Ryoho, 2011,38(8):1325-8. [7] Takeyoshi I, Hirai K, Miyamae Y, et al. Pathological complete remission using low-dose cisplatin plus S-1 for gastric cancer patient with liver metastases[J].Gan To Kagaku Ryoho, 20 13,40(1):91-3.
计量
- 文章访问数: 2246
- HTML全文浏览量: 489
- PDF下载量: 1090
下载:
