Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Int J Clin Oncol. 2010 Jun;15(3):287-93. doi: 10.1007/s10147-010-0054-9. Epub 2010 Mar 10.
Efficacy and safety of irinotecan and cisplatin administration every 2 weeks (biweekly regimen) or 4 weeks (4-weekly regimen) in patients with pretreated unresectable or recurrent gastric cancer was retrospectively evaluated.
Study patients comprised two cohorts: cohort 1, consisting of 31 patients received chemotherapy on a 4-weekly regimen; and cohort 2, consisting of 32 patients received chemotherapy on a biweekly regimen. In cohort 1, patients received irinotecan (70 mg/m(2)) on days 1 and 15 and cisplatin (80 mg/m(2)) on day 1 every 4 weeks; in cohort 2, patients received irinotecan (60 mg/m(2)) on day 1 and cisplatin (30 mg/m(2)) on day 1 every 2 weeks.
Response rates were for cohorts 1 and 2 were 26% (7/27) and 28% (7/25) in patients with measurable lesions, median progression-free survivals were 3.5 and 4.3 months, and median survival times after irinotecan and cisplatin initiation were 9.5 and 10.1 months, respectively. The incidence of grades 3 and 4 hematological toxicities in cohorts 1 and 2 were 74% and 44% for leukopenia, 81% and 53% for neutropenia, and 45% and 28% for anemia, respectively. Incidences of grades 3 and 4 nonhematological toxicities were 23% and 12% for nausea, 23% and 9% for vomiting, 19% and 12% for anorexia, and 6% and 6% for febrile neutropenia, respectively.
Irinotecan plus cisplatin chemotherapy administered on a biweekly regimen was comparable in efficacy to a 4-weekly regimen and might be more feasible than the 4-weekly regimen.
回顾性评估了伊立替康联合顺铂每 2 周(双周方案)或 4 周(4 周方案)给药方案治疗预处理不可切除或复发性胃癌患者的疗效和安全性。
研究患者包括两个队列:队列 1 由 31 例接受 4 周方案化疗的患者组成;队列 2 由 32 例接受双周方案化疗的患者组成。队列 1 中,患者每 4 周接受伊立替康(70mg/m2),第 1 和第 15 天;顺铂(80mg/m2),第 1 天;队列 2 中,患者每 2 周接受伊立替康(60mg/m2),第 1 天;顺铂(30mg/m2),第 1 天。
队列 1 和 2 中可测量病变患者的缓解率分别为 26%(7/27)和 28%(7/25),中位无进展生存期分别为 3.5 个月和 4.3 个月,伊立替康和顺铂起始后中位生存时间分别为 9.5 个月和 10.1 个月。队列 1 和 2 中 3 级和 4 级血液学毒性的发生率分别为白细胞减少症 74%和 44%,中性粒细胞减少症 81%和 53%,贫血症 45%和 28%。3 级和 4 级非血液学毒性的发生率分别为恶心 23%和 12%,呕吐 23%和 9%,厌食症 19%和 12%,发热性中性粒细胞减少症 6%和 6%。
伊立替康联合顺铂双周方案的疗效与 4 周方案相当,且可能比 4 周方案更具可行性。