Kim Jae Hyun, Park Seun Ja, Park Moo In, Moon Won, Kim Sung Eun, Ku Ki Hwan, Song Sung Eun, Kim Je Hun
Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 602-702, Korea.
Korean J Gastroenterol. 2014 Jan 25;63(1):18-24. doi: 10.4166/kjg.2014.63.1.18.
BACKGROUND/AIMS: The incidence of colorectal cancer has been increasing every year in Korea. Irinotecan- or oxaliplatin-based regimens including biologic agents are known to be effective in patients with advanced colorectal cancer. But in practice, FOLFOX (combination of oxaliplatin, 5-fluorouracil, and leucovorin) or FOLFIRI (combination of irinotecan, 5-fluorouracil, and leucovorin) regimens without biologic agents are more commonly used in Korea due to of the high costs of biologic agents. The aim of this study was to evaluate the efficacy and toxicity of FOLFIRI following FOLFOX4 in patients with advanced colorectal cancer.
A total of 54 patients with advanced colorectal cancer who were treated between May 2005 and May 2013 with FOLFOX4 as first-line chemotherapy and with FOLFIRI as second-line chemotherapy at Kosin University Gospel Hospital (Busan, Korea) were reviewed retrospectively.
A total of 54 patients received second-line FOLFIRI chemotherapy. Five patients (9.3%) had a partial response, 29 patients (53.7%) had a stable disease. The median overall survival was 8.90 months and the median time to progression was 4.33 months. Toxicities were tolerable.
In a Korean population, FOLFIRI as second-line chemotherapy is effective and well tolerated in patients with advanced colorectal cancer after failure of FOLFOX4. Although the efficacy of FOLFIRI in this study was lower than that of second-line FOLFIRI with biologic agents, these results can help in the formulation of a treatment strategy for financially troubled patients.
背景/目的：韩国结直肠癌的发病率逐年上升。含生物制剂的伊立替康或奥沙利铂方案已知对晚期结直肠癌患者有效。但在实际应用中，由于生物制剂成本高昂，在韩国不含生物制剂的FOLFOX（奥沙利铂、5-氟尿嘧啶和亚叶酸钙联合方案）或FOLFIRI（伊立替康、5-氟尿嘧啶和亚叶酸钙联合方案）方案更为常用。本研究的目的是评估FOLFOX4治疗失败后FOLFIRI方案对晚期结直肠癌患者的疗效和毒性。
回顾性分析2005年5月至2013年5月在釜山的加图立大学福音医院接受FOLFOX4作为一线化疗、FOLFIRI作为二线化疗的54例晚期结直肠癌患者。
共有54例患者接受了二线FOLFIRI化疗。5例患者（9.3%）部分缓解，29例患者（53.7%）病情稳定。中位总生存期为8.90个月，中位疾病进展时间为4.33个月。毒性反应可耐受。
在韩国人群中，FOLFIRI作为二线化疗对FOLFOX4治疗失败的晚期结直肠癌患者有效且耐受性良好。尽管本研究中FOLFIRI的疗效低于含生物制剂的二线FOLFIRI，但这些结果有助于为经济困难的患者制定治疗策略。
