伊立替康作为一线S-1或S-1/顺铂治疗失败后转移性胃癌二线治疗的关键化疗药物。

Irinotecan as the key chemotherapeutic agent in second-line treatment of metastatic gastric cancer after failure of first-line S-1 or S-1/CDDP therapy.

作者信息

Goto Akira, Sukawa Yasutaka, Igarashi Hisayoshi, Onodera Kei, Aoki Yuka, Suzuki Kazuya, Yonezawa Kazuhiko, Yawata Atsushi, Kobayashi Toshihisa, Kaneto Hiroyuki, Shimizu Haruo, Wakasugi Hideki, Matsunaga Yasutaka, Itoh Miki, Okuda Hiroyuki, Arimura Yoshiaki, Shinomura Yasuhisa

机构信息

Dept. of Gastroenterology, Kushiro City General Hospital.

出版信息

Gan To Kagaku Ryoho. 2011 Sep;38(9):1461-6.

PMID:21945893

Abstract

BACKGROUND

S-1, an oral fluoropyrimidine, is one of the standard chemotherapeutic agents for the treatment of metastatic gastric cancer(MGC). However, the most effective second-line regimen after failure of treatment with first-line agents such as S-1 is yet to be determined. The aim of this study was to investigate the various second-line chemotherapy regimens in MGC patients.

METHODS

We retrospectively studied patients with MGC who received second-line treatment after failure of the first-line S-1 or S-1/cisplatin treatment. The overall survival times with each second-line regimen were determined using the Kaplan-Meier method, and the effect on overall survival was analyzed using Cox regression analysis.

RESULTS

The median survival time for all patients was 14. 2 months(95% confidence interval(CI): 12. 88-15. 43 months)with a 1-year survival rate of 60. 4%. Kaplan-Meier analysis revealed that the second-line regimens containing irinotecan significantly improved the median survival time as compared to regimens without irinotecan(median survival time: 16. 5 and 13. 8 months, respectively). Cox regression analysis showed that irinotecan-containing regimens were associated with improved overall survival(hazard ratio: 0. 165; 95% CI: 0. 041-0. 665).

CONCLUSION

The use of irinotecan-containing regimens as second-line chemotherapy after failure of first-line S-1 therapy may be beneficial for MGC patients.

摘要

背景

S-1是一种口服氟嘧啶，是治疗转移性胃癌（MGC）的标准化疗药物之一。然而，一线药物如S-1治疗失败后最有效的二线治疗方案尚未确定。本研究的目的是调查MGC患者的各种二线化疗方案。

方法

我们回顾性研究了一线S-1或S-1/顺铂治疗失败后接受二线治疗的MGC患者。采用Kaplan-Meier方法确定每种二线治疗方案的总生存时间，并使用Cox回归分析分析对总生存的影响。

结果

所有患者的中位生存时间为14.2个月（95%置信区间（CI）：12.88-15.43个月），1年生存率为60.4%。Kaplan-Meier分析显示，与不含伊立替康的方案相比，含伊立替康的二线方案显著提高了中位生存时间（中位生存时间分别为16.5个月和13.8个月）。Cox回归分析表明，含伊立替康的方案与总生存改善相关（风险比：0.165；95%CI：0.041-0.665）。