Fiorentini G, Lucchi S R, Giovanis P, Cantore M, Guadagni S, Papiani G
Department of Oncology and Hematology, City Hospital S Maria delle Croci, Ravenna, Italy.
Tumori. 2001 Nov-Dec;87(6):388-90. doi: 10.1177/030089160108700606.
Hepatic arterial infusion chemotherapy is a promising approach in liver metastases from colorectal cancer, but chemical hepatitis, biliary sclerosis, arterial thrombosis and right upper quadrant pain are limiting factors. Irinotecan (CPT-11) is an active drug in colorectal cancer. We planned a short hepatic arterial infusion of CPT-11 to describe the toxicity, to determine the dose-limiting toxicity, and to define the doses of CPT-11 to be recommended for phase II studies.
Fourteen patients with a median liver substitution of 30% (10-60%) were enrolled. All patients received hepatic arterial infusion chemotherapy with CPT-11 on an outpatient basis every 3 weeks as a short, 30-min infusion.
At 240 mg/m2, 2 of 4 patients experienced grade 4 diarrhea and neutropenia, and 3 of them also reported grade 4 abdominal pain of the right upper quadrant. The maximum tolerated dose was reached at 240 mg/m2. The recommended doses of CPT-11 for phase II studies is 200 mg/m2, given every 3 weeks.
CPT-11 presents a low hepatic toxic profile and could be considered a new active drug, suitable for hepatic arterial infusion in liver metastases from colorectal cancer.
肝动脉灌注化疗是治疗结直肠癌肝转移的一种有前景的方法，但化学性肝炎、胆汁性硬化、动脉血栓形成和右上腹疼痛是限制因素。伊立替康（CPT-11）是结直肠癌的一种活性药物。我们计划进行短疗程的CPT-11肝动脉灌注，以描述其毒性，确定剂量限制毒性，并确定推荐用于II期研究的CPT-11剂量。
纳入14例肝脏替代中位数为30%（10%-60%）的患者。所有患者每3周在门诊接受一次CPT-11肝动脉灌注化疗，为30分钟的短疗程灌注。
在240mg/m²剂量时，4例患者中有2例出现4级腹泻和中性粒细胞减少，其中3例还报告有4级右上腹腹痛。最大耐受剂量为240mg/m²。推荐用于II期研究的CPT-11剂量为每3周200mg/m²。
CPT-11具有较低的肝脏毒性，可被视为一种新的活性药物，适用于结直肠癌肝转移的肝动脉灌注。
