结直肠癌的药理学治疗现状。
Current status of pharmacological treatment of colorectal cancer.
机构信息
Reyhan Akhtar, Shammy Chandel, Pooja Sarotra, Bikash Medhi, Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
出版信息
World J Gastrointest Oncol. 2014 Jun 15;6(6):177-83. doi: 10.4251/wjgo.v6.i6.177.
AIM
To review the clinical trials for the development in drugs for chemotherapeutic treatment of colorectal cancer (CRC).
METHODS
A systematic review identified randomized controlled trials (RCTs) assessing drugs for the treatment of CRC or adenomatous polyps from www.clinicaltrials.gov. Various online medical databases were searched for relevant publications.
RESULTS
Combination treatment regimens of standard drugs with newer agents have been shown to improve overall survival, disease-free survival, time to progression and quality of life compared to that with standard drugs alone in patients with advanced colorectal cancer. The FOLFOXIRI regimen has been associated with a significantly higher response rate, progression-free survival and overall survival compared to the FOLFIRI regimen.
CONCLUSION
Oxaliplatin plus intravenous bolus fluorouracil and leucovorin has been shown to be superior for disease-free survival when compared to intravenous bolus fluorouracil and leucovorin. In addition, oxaliplatin regimens were more likely to result in successful surgical resections. First line treatment with cetuximab plus fluorouracil, leucovorin and irinotecan has been found to reduce the risk of metastatic progression in patients with epidermal growth factor receptor-positive colorectal cancer with unresectable metastases. The addition of bevacizumab has been shown to significantly increase overall and progression-free survival when given in combination with standard therapy.
目的
综述化疗治疗结直肠癌（CRC）药物研发的临床试验。
方法
通过 www.clinicaltrials.gov 系统检索评估 CRC 或腺瘤性息肉治疗药物的随机对照试验（RCT）。还检索了各种在线医学数据库以获取相关文献。
结果
与单独使用标准药物相比，标准药物联合新型药物的联合治疗方案可改善晚期结直肠癌患者的总生存期、无病生存期、进展时间和生活质量。与 FOLFIRI 方案相比，FOLFOXIRI 方案与更高的缓解率、无进展生存期和总生存期相关。
结论
与静脉推注氟尿嘧啶和亚叶酸相比，奥沙利铂联合静脉推注氟尿嘧啶和亚叶酸在无病生存期方面显示出优越性。此外，奥沙利铂方案更有可能导致成功的手术切除。对于不可切除转移的表皮生长因子受体阳性结直肠癌患者，西妥昔单抗联合氟尿嘧啶、亚叶酸和伊立替康的一线治疗已被发现可降低转移进展的风险。贝伐单抗联合标准治疗可显著提高总生存期和无进展生存期。
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