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奥沙利铂肝动脉灌注联合静脉注射伊立替康、亚叶酸钙和氟尿嘧啶治疗不可切除肝转移结直肠癌的疗效与安全性

The efficacy and safety of hepatic arterial infusion of oxaliplatin plus intravenous irinotecan, leucovorin and fluorouracil in colorectal cancer with inoperable hepatic metastasis.

作者信息

Volovat Simona R, Volovat Constantin, Negru Serban M, Danciu Mihai, Scripcariu Viorel

机构信息

a Regional Institute of Oncology , University of Medicine and Pharmacy 'Gr.T.Popa' , Iasi , Romania.

b Center of Oncology Euroclinic , Iasi , Romania.

出版信息

J Chemother. 2016 Jun;28(3):235-41. doi: 10.1179/1973947815Y.0000000042.

Abstract

Hepatic arterial infusion (HAI) was evaluated for different drugs to treat hepatic metastasis from colorectal cancer (CRC). Combination treatment with 5-fluorouracil (5-FU), leucovorin, oxaliplatin and irinotecan (FOLFOXIRI) is effective for CRC. A phase II study was conducted to evaluate concomitant HAI administration of oxaliplatin and intravenous leucovorin, 5-FU and irinotecan (FOLFIRI) for patients with inoperable liver metastasis, which had chemotherapy with oxaliplatin (OX) 85 mg/m(2) HAI plus systemic intravenous chemotherapy [leucovorin 200 mg/m(2), 5-FU 2400 mg/m(2) and irinotecan (IRI) 160 mg/m(2) in 48 hours]. We treated 24 patients. Neutropaenia was the most frequent toxicity. The main HAI-related toxicity was pain. Two patients (8%) obtained complete response and 17 patients (70%) partial response, giving an objective response rate of 78%. Median follow-up was 22.8 months, and median overall and disease-free survival times were 29 and 20 months, respectively. Therefore, OX HAI and intravenous FOLFIRI is feasible and effective in patients with metastatic CRC.

摘要

对不同药物进行肝动脉灌注(HAI)以治疗结直肠癌(CRC)肝转移。5-氟尿嘧啶(5-FU)、亚叶酸钙、奥沙利铂和伊立替康联合治疗(FOLFOXIRI)对CRC有效。开展了一项II期研究,评估对无法手术切除的肝转移患者同时进行HAI给予奥沙利铂以及静脉给予亚叶酸钙、5-FU和伊立替康(FOLFIRI)的疗效,其中奥沙利铂(OX)85mg/m²进行HAI并联合全身静脉化疗[亚叶酸钙200mg/m²、5-FU 2400mg/m²和伊立替康(IRI)160mg/m²在48小时内给予]。我们治疗了24例患者。中性粒细胞减少是最常见的毒性反应。与HAI相关的主要毒性是疼痛。2例患者(8%)获得完全缓解,17例患者(70%)获得部分缓解,客观缓解率为78%。中位随访时间为22.8个月,中位总生存期和无病生存期分别为29个月和20个月。因此,OX HAI联合静脉给予FOLFIRI对转移性CRC患者是可行且有效的。

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