伊立替康作为不可切除或复发性胃癌三线化疗的疗效。
Efficacy of Irinotecan as Third-line Chemotherapy for Unresectable or Recurrent Gastric Cancer.
机构信息
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
出版信息
In Vivo. 2020 Mar-Apr;34(2):903-908. doi: 10.21873/invivo.11856.
AIM
To evaluate the efficacy and safety of third-line chemotherapy (CTx) for patients with unresectable or recurrent gastric cancer (GC) refractory to S-1 with or without platinum and taxanes.
PATIENTS AND METHODS
We retrospectively analyzed clinicopathological and survival data of 26 patients who underwent third-line CTx.
RESULTS
Irinotecan therapy (odds ratio=0.12, 95% confidence interval=0.02-0.38; p<0.01) and ≥2 cycles of third-line CTx (odds ratio=0.01, 95% confidence intervaI=0.01-0.11; p<0.01) were independent predictors of longer progression-free survival in multivariate Cox regression analysis. In 18 patients (69%) receiving irinotecan, the overall response rate was 11%, and the disease control rate was 44%. Median progression-free and overall survival were 3.5 and 11.3 months, respectively. Ten patients (56%) had grade 3-4 toxicities, which were managed.
CONCLUSION
Irinotecan therapy may become optimal and tolerated in the third-line setting to prolong progression-free survival by increasing the number of treatment cycles.
目的
评估三線化疗（CTx）对 S-1 联合或不联合铂类和紫杉类药物治疗后不可切除或復發性胃癌（GC）患者的疗效和安全性。
方法
我们回顾性分析了 26 例接受三线 CTx 的患者的臨床病理和生存数据。
结果
在多因素 Cox 回归分析中，伊立替康治疗（优势比=0.12，95%置信区间=0.02-0.38；p<0.01）和三线 CTx 治疗≥2 个周期（优势比=0.01，95%置信区间=0.01-0.11；p<0.01）是无进展生存期延长的独立预测因素。在 18 例接受伊立替康治疗的患者中，总缓解率为 11%，疾病控制率为 44%。中位无进展生存期和总生存期分别为 3.5 个月和 11.3 个月。10 例（56%）患者发生 3-4 级毒性，经处理后可耐受。
结论
伊立替康治疗可能成为三线治疗中的最佳选择，通过增加治疗周期数来延长无进展生存期，且患者可耐受。
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