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目的:探讨FOLFOXIRI方案〔伊立替康(CPT-11)+奥沙利铂(L-OHP)+5-氟尿嘧啶(5-FU)+甲酰四氢叶酸(LV)〕一线治疗复发或转移性结直肠癌的临床疗效和安全性。方法:对46例复发或转移性结直肠癌患者,采用FOLFO-XIRI方案治疗。CPT-11 150 mg/m2,持续静脉滴入90 min,d1;L-OHP 65 mg/m2,持续静脉滴入2 h,d2;LV200 mg/m2,持续静脉滴入2 h,d2;5-FU 400 mg/m2,静脉推注,d2,d3;5-FU600 mg/m2持续静脉滴入22 h(泵),d2,d3;每14 d重复。观察近期疗效及不良反应。结果:46例患者中,完全缓解(CR)2例(4.3%),部分缓解(PR)25例(54.3%),稳定(SD)14例(30.4%),疾病进展(PD)6例(10.9%)。未手术的患者中位疾病进展时间(TTP)10.2个月。安全性评价:发生率最高的Ⅲ、Ⅳ度毒副反应是中性粒细胞减少13例(28.0%),腹泻6例(13.0%)。结论:FOLFOXIRI方案一线治疗复发或转移性结直肠癌安全、有效。
OBJECTIVE: To investigate the efficacy and safety of FOLFOXIRI regimen in the treatment of recurrent or metastatic nodes in first-line treatment with first-line treatment of CPT-11 plus L-OHP plus 5-fluorouracil and leucovorin (LV) Clinical efficacy and safety of rectal cancer. Methods: Forty-six patients with recurrent or metastatic colorectal cancer were treated with FOLFO-XIRI regimen. CPT-11 150 mg / m2, continuous intravenous infusion of 90 min, d1; L-OHP 65 mg / m2, continuous intravenous infusion of 2 h, d2; LV200 mg / m2, continuous intravenous infusion of 2 h, FU 400 mg / m2, intravenous injection, d2, d3; 5-FU 600 mg / m2 continuous intravenous infusion of 22 h (pump), d2, d3; repeated every 14 d. Observation of short-term efficacy and adverse reactions. Results: Among the 46 patients, complete remission (CR) occurred in 2 cases (4.3%), partial remission (PR) in 25 cases (54.3%), stable (SD) in 14 cases (30.4%) and disease progression 10.9%). The median duration of disease progression (TTP) was 10.2 months in the untreated patient. Safety evaluation: the highest incidence of Ⅲ, Ⅳ degree of toxicity is neutropenia in 13 cases (28.0%), diarrhea in 6 cases (13.0%). Conclusion: FOLFOXIRI regimen is safe and effective in the first-line treatment of recurrent or metastatic colorectal cancer.