Kalofonos Haralabos P, Kardamakis Dimitrios, Bamias Aristotelis, Skarlos Dimosthenis, Papakostas Pavlos, Bafaloukos Dimitrios, Sakantamis Athanasios, Pavlidis Nicolas, Fountzilas Georgios
Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, Rion 265 00, Greece.
Anticancer Res. 2003 Mar-Apr;23(2C):1687-91.
The addition of CPT-11 to 5FU/leucovorin resulted in survival benefit in patients with advanced colorectal cancer suggesting that this combination could be used successfully in the adjuvant setting. We studied the toxicity profile of postoperatively administered CPT-11 plus leucovorin (LV)-modulated 5FU and radiotherapy in patients with rectal cancer.
Thirty-seven patients with Dukes' B2 and C rectal adenocarcinoma were treated with CPT-11, 80 mg/m2 ii.v. over 90 minutes followed by LV 200 mg/m2 over 2 hours and 5FU 450 mg/m2 i.v.-bolus weekly for 4 weeks followed by a 2-week rest period. One cycle included 4 infusions. The first cycle of chemotherapy was followed by pelvic radiation to a total dose of 45 Gy to the whole pelvis and a boost of 5 Gy to the tumor bed. 5FU was administered daily as a rapid infusion during the first 3 as well as the last 3 days of radiotherapy. CPT-11 plus LV-modulated 5FU was continued for a total of 6 cycles or consent withdrawal.
The main toxicity was reversible diarrhea (grade 3 and 4) in 9 (26%) patients during chemotherapy and in 3 (9%) patients during chemoradiotherapy. Furthermore, grade 3 leucopenia in 2 (6%) and 1 (3%) patient was observed during chemotherapy and chemoradiotherapy, respectively.
This study provides evidence that adjuvant therapy using CPT-11 plus LV modulated 5FU and radiotherapy can be used in patients with rectal cancer.
在晚期结直肠癌患者中，CPT-11联合5氟尿嘧啶/亚叶酸钙可带来生存获益，这表明该联合方案可成功用于辅助治疗。我们研究了直肠癌患者术后给予CPT-11联合亚叶酸钙（LV）调节的5氟尿嘧啶及放疗的毒性特征。
37例Dukes B2和C期直肠腺癌患者接受CPT-11治疗，剂量为80 mg/m²，静脉滴注90分钟，随后给予LV 200 mg/m²，静脉滴注2小时，5氟尿嘧啶450 mg/m²静脉推注，每周1次，共4周，随后休息2周。1个周期包括4次输注。第1周期化疗后进行盆腔放疗，全盆腔总剂量为45 Gy，肿瘤床追加5 Gy。在放疗的前3天及最后3天，5氟尿嘧啶每日快速输注。CPT-11联合LV调节的5氟尿嘧啶持续应用共6个周期或直至患者撤回同意书。
主要毒性反应为化疗期间9例（26%）患者出现可逆性腹泻（3级和4级），放化疗期间3例（9%）患者出现可逆性腹泻。此外，化疗期间和放化疗期间分别观察到2例（6%）和1例（3%）患者出现3级白细胞减少。
本研究提供了证据，表明CPT-11联合LV调节的5氟尿嘧啶及放疗的辅助治疗可用于直肠癌患者。
