Kamoshita Norikazu, Makita Fujio, Kobayashi Mitsunobu, Matsuzaki Yutaka, Kabeya Kenji
Dept. of Surgery, National Hospital Organization Nishigunma National Hospital.
Gan To Kagaku Ryoho. 2007 Mar;34(3):397-401.
We have treated 14 advanced and metastatic colorectal cancers with irinotecan (CPT-11) plus fluorouracil (5-FU) and l-leucovorin (l-LV) combination chemotherapy. The 14 patients consisted of 8 males and 6 females with a mean age of 65 years. We diagnosed adenocarcinoma of the colon in 10 patients and of the rectum in 4 patients. Four patients had liver metastases, five had lung metastases, and one had both, while one had lung and lymph node metastases, two had lymph node metastases and one had a local recurrence. The chemotherapy consisted of CPT-11 100 mg/m(2) div, as a 150-minute infusion, simultaneously l-LV 10 mg/m(2) div, as a 30-minute infusion, followed by 5-FU 500 mg/m(2) iv, as a bolus injection. This treatment was administered weekly for 2 weeks followed by a 2-week rest period and repeated every 4 weeks. All patients received this regimen as first-line chemotherapy. All patients were evaluated for efficacy 1 CR, 2 PR, 9 SD, and 2 PD. The overall response rate was 21.4% with a median time to progression of 8.1 months and a median survival time of 18.6 months. Grade 3 nausea, diarrhea and the suppression of white blood cells were seen in 3 patients, respectively. All other adverse reactions were mild (grade 1 or 2). Except for one patient,residual patients were able to receive the systemic chemotherapy on schedule. CPT-11/5-FU/l-LV combination chemotherapy appears to be effective first-line chemotherapy for advanced and metastatic colorectal cancer.
我们采用伊立替康（CPT-11）联合氟尿嘧啶（5-FU）及亚叶酸钙（l-LV）的联合化疗方案治疗了14例晚期和转移性结直肠癌患者。这14例患者中，男性8例，女性6例，平均年龄65岁。我们诊断出10例为结肠癌腺癌，4例为直肠癌腺癌。4例患者有肝转移，5例有肺转移，1例同时有肝肺转移，1例有肺和淋巴结转移，2例有淋巴结转移，1例有局部复发。化疗方案为：CPT-11 100mg/m²，分剂量静脉滴注150分钟，同时l-LV 10mg/m²，分剂量静脉滴注30分钟，随后5-FU 500mg/m²静脉推注。该治疗每周进行2周，随后休息2周，每4周重复一次。所有患者均接受该方案作为一线化疗。所有患者均接受疗效评估，结果为1例完全缓解（CR），2例部分缓解（PR），9例疾病稳定（SD），2例疾病进展（PD）。总缓解率为21.4%，中位疾病进展时间为8.1个月，中位生存时间为18.6个月。分别有3例患者出现3级恶心、腹泻和白细胞减少。所有其他不良反应均较轻（1级或2级）。除1例患者外，其余患者均能按时接受全身化疗。CPT-11/5-FU/l-LV联合化疗似乎是晚期和转移性结直肠癌有效的一线化疗方案。
