奥沙利铂辅助化疗失败后一线再引入治疗晚期结直肠癌的研究

陈永昌; 安欣; 张乐; 陈翠; 徐瑞华; 李宇红; 王风华

doi:10.3969/j.issn.1000-8179.2012.13.013

奥沙利铂辅助化疗失败后一线再引入治疗晚期结直肠癌的研究

Oxaliplatin Reintroduction in Colorectal Cancer Patients Following Disease Progression after Adj uvant Oxaliplatin—Based Chemotherapy

摘要

摘要:
目的奥沙利铂辅助化疗后疾病进展的晚期结直肠癌患者优先推荐含伊立替康的方案, 然而部分患者因费用或禁忌症不能接受伊立替康的治疗。本回顾性研究探讨奥沙利铂辅助化疗失败后一线再引入治疗的疗效和安全性。
方法奥沙利铂辅助化疗结束6个月后疾病进展一线治疗再引入的27例晚期结直肠癌患者纳入研究, 化疗方案包括mFOLFOX6和CapeOX。
结果 27例均可评价疗效, 完全缓解1例, 部分缓解7例, 稳定7例, 总有效率29.6%, 疾病控制率55.5%, 中位疾病进展时间和中位总生存分别为7.26个月(95%CI, 6.34~13.43个月)和19.1个月(95%CI, 19.3~33.1个月)。Ⅲ~Ⅳ度不良反应包括Ⅲ度粒细胞下降2例、Ⅲ度贫血1例、Ⅲ度和Ⅴ度血小板下降各1例、Ⅲ度呕吐1例、Ⅲ度口腔粘膜炎1例、Ⅲ度神经毒性2例。
结论对于奥沙利铂辅助化疗失败后不能接受伊立替康治疗的晚期结直肠癌患者, 奥沙利铂再引入可以给患者带来生存获益, 安全可行。

Abstract:
Objective To investigate Oxaliplatin reintroduction in patients following disease progression after oxaliplatin-based adjuvant chemotherapy.
Methods Oxaliplatin was reintroduced in 27 evaluable patients with advanced colorectal cancer following diseaseprogression within six months prior to Oxaliplatin-based adjuvant chemotherapy. The Oxaliplatin-based regimens included FOLFOXand CapeOX.
Results After Oxaliplatin-based regimen reintroduction, one patient achieved complete remission, seven had partial remissions; and seven had stable diseases. The overall response rate was 29.6%, and disease control rate was 55.5%. The median time toprogression was 7.26 months ( 95% CI, 6.34 to 13.43 months ), and the median overall survival was 19.1 months ( 95% CI, 19.3 to 33.1months ). The grade Ⅲ/Ⅳ toxicities included grade Ⅲ neutropenia (2 pts ), grade Ⅲ anemia ( 1 pt ), grade Ⅲ/Ⅳthrombocytopenia ( 1pt ), grade Ⅲ vomiting (1pt),grade Ⅲ mucositis ( 1 pt ), and grade Ⅲ neuropathy (2pts).
Conclusion Oxaliplatin reintroduction in advanced colorectal cancer patients following disease progression after Oxaliplatin-based adjuvant chemotherapy, without Irinotecan, is feasible.

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