Li Yu-Hong, Wang Feng-Hua, Zhang Dong-Sheng, Wang Zhi-Qiang, Feng Fen, Zhang Li, Xu Rui-Hua, Jiang Wen-Qi, He You-Jian
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, PR China.
Ai Zheng. 2009 Sep;28(9):913-8. doi: 10.5732/cjc.008.10571.
Irinotecan (CPT-11), oxaliplatin, 5-fluorouracil (5-FU) and capecitabine are main active agents for advanced colorectal cancer. FORFIRI regimen is recommended for the patients who were treated with oxaliplatin plus 5-FU or capecitabine previously. This study was to investigate the efficacy and safety of FORFIRI regimen in treating advanced colorectal cancer failing to prior oxaliplatin-based chemotherapy, and analyze the impacts of clinical factors on the responses.
A total of 90 patients with advanced colorectal adenocarcinoma, who had received prior adjuvant FOLFOX6 regimen and progressed within 12 months after the completion of therapy or had no response to prior FOLFOX6/CapeOX regimen as first-line therapy, were treated with FORFIRI regimen. The efficacy and adverse events were observed.
Of the 81 evaluable patients, two achieved complete remission, 20 achieved partial remission and 34 had stable disease. The overall response rate was 27.2% and disease control rate was 69.1%. The median time to progression was 6.8 months (95% CI, 4.9-8.8 months) and median overall survival time was 18.8 months (95% CI, 17.5-20.2 months). The main adverse events time were nausea, vomiting, neutropenia, alopecia, fatigue, impaired liver function, oral mucositis and diarrhea. Grade III adverse events included alopecia in 15 patients (16.7%), vomiting in 10 patients (11.1%), nausea in eight patients (8.9%), neutropenia in five patients (5.6%), impaired liver function in two patients (2.2%) and oral mucositis in two patients (2.2%).
FOLFIRI regimen is effective and well-tolerated as salvage therapy for advanced colorectal cancer failing to prior FOLFOX6/CapeOX regimen, and thus can be used widely.
伊立替康（CPT - 11）、奥沙利铂、5 - 氟尿嘧啶（5 - FU）和卡培他滨是晚期结直肠癌的主要活性药物。对于先前接受过奥沙利铂联合5 - FU或卡培他滨治疗的患者，推荐使用FOLFIRI方案。本研究旨在探讨FOLFIRI方案治疗先前奥沙利铂为基础的化疗失败的晚期结直肠癌的疗效和安全性，并分析临床因素对反应的影响。
共有90例晚期结直肠腺癌患者，这些患者先前接受过辅助性FOLFOX6方案治疗且在治疗完成后12个月内病情进展，或作为一线治疗对先前的FOLFOX6/CapeOX方案无反应，接受FOLFIRI方案治疗。观察疗效和不良事件。
81例可评估患者中，2例达到完全缓解，20例达到部分缓解，34例病情稳定。总缓解率为27.2%，疾病控制率为69.1%。中位疾病进展时间为6.8个月（95%CI，4.9 - 8.8个月），中位总生存时间为18.8个月（95%CI，17.5 - 20.2个月）。主要不良事件为恶心、呕吐、中性粒细胞减少、脱发、疲劳、肝功能损害、口腔黏膜炎和腹泻。Ⅲ级不良事件包括15例患者（16.7%）脱发、10例患者（11.1%）呕吐、8例患者（8.9%）恶心、5例患者（5.6%）中性粒细胞减少、2例患者（2.2%）肝功能损害和2例患者（2.2%）口腔黏膜炎。
FOLFIRI方案作为先前FOLFOX6/CapeOX方案失败的晚期结直肠癌的挽救治疗有效且耐受性良好，因此可广泛应用。
