FOLFOXIRI方案治疗中国晚期结直肠癌患者的疗效和安全性

目的评价FOLFOXIRI方案(氟尿嘧啶/亚叶酸钙+奥沙利铂+伊立替康)治疗中国晚期结直肠癌患者的疗效和安全性。方法按照Ⅰ期临床试验设计以探索FOLFOXIRI方案的最大耐受剂量,固定氟尿嘧啶和奥沙利铂剂量,按照150、165和180 mg/m2(静脉输注90 min)3个水平逐级提升伊立替康的剂量。针对出现剂量限制性毒性的患者进行UGT1A1基因分型检测。结果共12例晚期结直肠癌患者纳入研究,FOLFOXIRI方案的推荐剂量为奥沙利铂85 mg/m2,亚叶酸钙200 mg/m2,氟尿嘧啶2 400 mg/m2(持续静脉滴注44 h),第1天给药;伊立替康150 mg/m2,第8天给药;每14...

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Published in中华肿瘤杂志 Vol. 39; no. 5; pp. 380 - 383
Main Author 宋岩 李伟伟 黄镜
Format Journal Article
LanguageChinese
Published 100021,国家癌症中心 中国医学科学院 北京协和医学院肿瘤医院内科%453100,新乡医学院附属第一医院肿瘤内科 2017
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ISSN0253-3766
DOI10.3760/cma.j.issn.0253-3766.2017.05.012

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Summary:目的评价FOLFOXIRI方案(氟尿嘧啶/亚叶酸钙+奥沙利铂+伊立替康)治疗中国晚期结直肠癌患者的疗效和安全性。方法按照Ⅰ期临床试验设计以探索FOLFOXIRI方案的最大耐受剂量,固定氟尿嘧啶和奥沙利铂剂量,按照150、165和180 mg/m2(静脉输注90 min)3个水平逐级提升伊立替康的剂量。针对出现剂量限制性毒性的患者进行UGT1A1基因分型检测。结果共12例晚期结直肠癌患者纳入研究,FOLFOXIRI方案的推荐剂量为奥沙利铂85 mg/m2,亚叶酸钙200 mg/m2,氟尿嘧啶2 400 mg/m2(持续静脉滴注44 h),第1天给药;伊立替康150 mg/m2,第8天给药;每14 d为1个周期。常见不良反应为恶心、腹泻、白细胞减少、中性粒细胞减少和乏力,剂量限制性毒性为腹泻和中性粒细胞减少伴发热。全组有效率为66.7%。结论FOLFOXIRI方案治疗中国晚期结直肠癌患者安全、有效。
Bibliography:ObjectiveTo establish the maximum tolerated dose (MTD) of 5-fluorouracil, leucovorin, oxaliplatin and irinotecan (FOLFOXIRI), and to evaluate the safety and efficacy in Chinese patients with advanced colorectal cancer.MethodsPatients were treated with a regimen consisting of infusional 5-fluorouracil (2 400 mg/m2 on day 1), leucovorin (200 mg/m2 on day 1), oxaliplatin (85 mg/m2 on day 1), and irinotecan (at doses from 150 to 180 mg/m2 on day 8) according to the dose-escalation schema. Treatment was repeated every 14 days. The UDP-glucuronosyl transferase (UGT) 1A1 genotypes were analyzed in the patients with dose-limiting toxicity (DLT).ResultsA total of 12 patients with advanced colorectal cancer were included. The MTD of FOLFOXIRI in these patients was oxaliplatin 85 mg/m2 day 1, leucovorin 200 mg/m2 day 1, 5-fluorouracil 2 400 mg/m2 day 1, and irinotecan 150 mg/m2 day 8 every 2 weeks. The most common toxicities were nausea, diarrhea, leukopenia, neutropenia and fatigue. The DLTs were febrile neutropenia an
ISSN:0253-3766
DOI:10.3760/cma.j.issn.0253-3766.2017.05.012