Department of Medical Oncology, Georges-Francois Leclerc Cancer Center, Dijon, France.
Anticancer Drugs. 2010 Jul;21(6):656-61. doi: 10.1097/CAD.0b013e328337d469.
The aim of this study was to evaluate the efficacy and safety of combined hepatic arterial infusion (HAI), which is a combination of raltitrexed and oxaliplatin, in refractory colorectal carcinoma with only liver metastases. Seventeen consecutive patients with unresectable metastatic colorectal cancer, after the failure of two lines of systemic chemotherapy, were treated with HAI raltitrexed (3 mg/m over 1 h) followed by oxaliplatin (130 mg/m over 2 h) every 3 weeks between January 2006 and January 2009. All patients presented with the metastatic disease limited to the liver and had failed at least two lines of chemotherapy, which contained oxaliplatin, irinotecan and a fluoropyrimidine. The median number of cycles was six (range 1-15). We observed three complete responses and eight partial responses among assessable patients (overall response rate in intention to treat, 65%; 95% confidence interval, 44.3-87.7%). The median time to progression was 10.5 months and the median survival time was 27.5 months. Toxicity included grade 3-4 neutropenia (in 17%), grade 3-4 thrombopenia (in 17%), and grade 2 abdominal pain (in 47%). In conclusion, the combination regimen of HAI raltitrexed and oxaliplatin is feasible and promising in patients who presented isolated hepatic metastases of colorectal cancer after failure of irinotecan and oxaliplatin treatment. Further evaluation of this combination is required.
本研究旨在评估联合肝动脉灌注(HAI)的疗效和安全性,该方案是雷替曲塞联合奥沙利铂的联合治疗,适用于仅存在肝转移的复发性结直肠癌患者。2006 年 1 月至 2009 年 1 月期间,对 17 例不可切除的转移性结直肠癌患者(在二线全身化疗失败后)进行了 HAI 雷替曲塞(3 mg/m,持续 1 h)联合奥沙利铂(130 mg/m,持续 2 h)治疗,每 3 周一次。所有患者的转移性疾病均局限于肝脏,且至少接受过两种包含奥沙利铂、伊立替康和氟嘧啶的化疗方案治疗失败。中位治疗周期数为 6 个(范围 1-15)。可评估患者中,我们观察到 3 例完全缓解和 8 例部分缓解(意向治疗的总缓解率为 65%;95%置信区间,44.3-87.7%)。中位无进展生存期为 10.5 个月,中位总生存期为 27.5 个月。毒性包括 3-4 级中性粒细胞减少症(17%)、3-4 级血小板减少症(17%)和 2 级腹痛(47%)。总之,对于伊立替康和奥沙利铂治疗失败后出现孤立性肝转移的结直肠癌患者,HAI 雷替曲塞和奥沙利铂联合治疗方案是可行且有前途的。需要进一步评估该联合方案。