CAJ | 학술논문

目的探讨伊立替康（ CPT-11）联合卡培他滨治疗转移性结直肠癌的近期疗效、毒性反应及生存状况。方法135例病理学证实的转移性结直肠腺癌患者接受了伊立替康350 mg/m2，静脉滴注90 min，第1天；卡培他滨1000 mg/m2，第1～14天，2次/d，口服；每3周为一周期，至少6周期方案治疗。评价近期疗效、毒副反应，并进行随访观察生存情况。结果全组135例患者疗效及毒副反应可评价。其中CR 0例， PR 63例（46.7％），SD 42例（31.1％），PD 30例（22.2％），总有效率（CR＋PR）46.7％，临床获益率（CR＋PR＋SD）77.8％。化疗中主要的毒副反应为骨髓抑制及消化道反应，可耐受。中位无进展生存期10个月（95％CI：6.8～13.1个月），中位生存时间为18个月（95％ CI：16.5～19.5个月）。统计1年生存率57.8％（78/135），2年生存率31.1％（42/135），3年生存率21.5％（29/135）。生存分析显示KPS评分、肿瘤转移部位多少及化疗后的近期疗效是生存的独立预后因素。结论伊立替康联合卡培他滨治疗转移性结直肠癌疗效肯定，毒副反应能耐受，给药方便，能一定程度改善生存，值得进一步研究。
목적탐토이립체강（ CPT-11）연합잡배타빈치료전이성결직장암적근기료효、독성반응급생존상황。방법135례병이학증실적전이성결직장선암환자접수료이립체강350 mg/m2，정맥적주90 min，제1천；잡배타빈1000 mg/m2，제1～14천，2차/d，구복；매3주위일주기，지소6주기방안치료。평개근기료효、독부반응，병진행수방관찰생존정황。결과전조135례환자료효급독부반응가평개。기중CR 0례， PR 63례（46.7％），SD 42례（31.1％），PD 30례（22.2％），총유효솔（CR＋PR）46.7％，림상획익솔（CR＋PR＋SD）77.8％。화료중주요적독부반응위골수억제급소화도반응，가내수。중위무진전생존기10개월（95％CI：6.8～13.1개월），중위생존시간위18개월（95％ CI：16.5～19.5개월）。통계1년생존솔57.8％（78/135），2년생존솔31.1％（42/135），3년생존솔21.5％（29/135）。생존분석현시KPS평분、종류전이부위다소급화료후적근기료효시생존적독립예후인소。결론이립체강연합잡배타빈치료전이성결직장암료효긍정，독부반응능내수，급약방편，능일정정도개선생존，치득진일보연구。
Objective To investigate the efficacy , the side effects and the survival of the combination of Irinotecan and Capecitabine in patients with metastatic colorectal cancer (MCRC).Methods 135 patients(median age 57 years) with histologic or cytologic confirmation of metastatic colorectal cancer received Irinotecan 350 mg/m2 intravenously on day 1 for 90 minutes and Capecitabine 1000 mg/m2 orally twice daily on days 1 to 14 in a 21-day treatment cycle as palliative chemotherapy .Each patient was received at least six cycles .Results The complete response rate(CR)was 0%(0/135).The partial response rate(PR)was 46.7%(63/135),stable disease(SD)rate was 31.1%(42/135),and disease progression(PD)rate was 22.2%(30/135).The overall rate(CR +PR)was 46.7%and the clinical benefit rate(RR+SD)was 77.8%.The main toxicities were leukopenia(48.9%),nausea and vomiting ( 44.4%) , diarrhea ( 64.4%) and hand-foot syndrome ( 28.9%) .No grade 4 events from the entire cohort was found .The median progression-free survival was 10 months ( 95% CI 6.8-13.1 months ) , and median overall survival was 18 months ( 95% CI 16.5-19.5 months ) .The 1-year, 2-year and 3-year survival rates were 57.8%,31.1%and 21.5%respectively .High Karnofsky performance status ,single metastatic lesion and response to the regimen indicated respectively good prognosis .Conclusion It was demonstrated that Irinotecan plus Capecitabine regimen was efficient and tolerable in MCRC .The regimen improve the survival moderately and merits further study .