FOLFIRI方案的时辰化疗在复发转移性结直肠癌的临床研究
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摘要
目的:探讨FOLFIRI方案的时辰化疗对比常规化疗治疗复发转移性结直肠癌患者的近期疗效及不良反应。方法:收集我院2015年9月—2017年9月收治的80例复发转移性结直肠癌患者,均采用FOLFIRI方案化疗,随机分成时辰化疗组(40例)和常规化疗组(40例),化疗2个周期后评估患者的有效率、疾病控制率及主要不良反应的发生率。结果:对比普通化疗组,时辰化疗组的有效率及疾病控制率更高,但结果无显著差异。时辰化疗组的白细胞及中性粒细胞减少发生率、贫血发生率、恶心呕吐发生率显著低于普通化疗组,两组的其他毒副作用发生率无显著差异。结论:FOLFIRI方案的时辰化疗近期疗效更好,且毒副作用发生率显著降低,患者耐受性更好,可作为复发转移性结直肠癌治疗的优选方案。
Objective: To explore the short-term effects and toxicities of chronochemotherapy compared with conventional chemotherapy with FOLFIRI regimen in patients with recurrent and/or metastatic colorectal cancer. Methods: 80 patients with recurrent and/or metastatic colorectal cancer who received treatment in our hospital during September 2015 to September 2017 were collected. They who underwent chemotherapy with FOLFIRI regimen were randomly divided into two groups,chronochemotherapy group( 40 patients) and a conventional chemotherapy group( 40 patients). Then the effective rate,disease control rate and incidence of main adverse reaction were evaluated. Results: Compared with conventional chemotherapy group,patients in chronochemotherapy group had higher effective rate and disease control rat,but there was no significant difference. The incidence of leucopenia and neutropenia,anemia,nausea and vomiting were significantly lower in chronochemotherapy group,but there was no significant difference in the incidence of other main adverse reactions between two group. Conclusion: Chronochemotherapy with FOLFIRI regimen has better curative effect,lower incidence of main adverse reaction and better tolerance so that it can be the preferred embodiment for the patients with recurrent and/or metastatic colorectal cancer.
Objective: To explore the short-term effects and toxicities of chronochemotherapy compared with conventional chemotherapy with FOLFIRI regimen in patients with recurrent and/or metastatic colorectal cancer. Methods: 80 patients with recurrent and/or metastatic colorectal cancer who received treatment in our hospital during September 2015 to September 2017 were collected. They who underwent chemotherapy with FOLFIRI regimen were randomly divided into two groups,chronochemotherapy group( 40 patients) and a conventional chemotherapy group( 40 patients). Then the effective rate,disease control rate and incidence of main adverse reaction were evaluated. Results: Compared with conventional chemotherapy group,patients in chronochemotherapy group had higher effective rate and disease control rat,but there was no significant difference. The incidence of leucopenia and neutropenia,anemia,nausea and vomiting were significantly lower in chronochemotherapy group,but there was no significant difference in the incidence of other main adverse reactions between two group. Conclusion: Chronochemotherapy with FOLFIRI regimen has better curative effect,lower incidence of main adverse reaction and better tolerance so that it can be the preferred embodiment for the patients with recurrent and/or metastatic colorectal cancer.
引文
[1]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].Ca Cancer J Clin,2016,66(2):115-132.
[2]Courtney RJ,Paul CL,Carey ML,et al.A population-based crosssectional study of colorectal cancer scrccning practices of first-degree reatives of colorectal cancer patients[J].BMC Cancer,2013,13(1):13.
[3]许岸高,姜泊,钟旭辉,等.广东地区近20年大肠癌临床特征的变化趋势[J].中华医学杂志,2006,86(4):272-275.
[4]Abolmaali K,Balakrishnan A,et al.Circadian variation in intestinal dihydropyrimidine dehydrogenase(DPD)expression:a potential mechanism for benefits of 5-FU chronochemotherapy[J].Syrgery,2009,146(2):269-273.
[5]范娟,韩云炜,陈枫,等.CPT-11在鼻咽癌裸鼠组织中时辰给药疗效观察及细胞周期分布变化的初步研究[J].中华肿瘤防治杂志,2008,15(9):699-702.
[6]中国抗癌协会癌症康复与姑息治疗专业委员会(CRPC),中国临床肿瘤学会抗肿瘤药物安全管理专家委员会(ASMC).肿瘤治疗相关呕吐防治指南(2014版)[J].临床肿瘤学杂志,2014,19(3):263-273.
[7]张怡,李中东.伊立替康的不良反应及处理[J].中国药物警戒,2006,3(5):271-273.
[8]周际昌,王奇璐.抗肿瘤药物的不良反应与疗效评价[M]//周际昌.实用肿瘤内科学.第2版.北京:人民卫生出版社,2003:29-46.
[9]周兆飞,陆建伟,尹必俭,等.含CPT-11时辰化疗的联合方案治疗晚期恶性肿瘤的临床研究[J].中国肿瘤外科杂志,2009,1(3):144-147.
[10]Xian LJ,Sun J,Cao QY,et al.Circadian rhythms of DNA synthesis in nasopharyngeal carcinoma cells[J].Chronobiol Int,2002,19(1):69-76.
[11]Herzog ED.Neurons and networks in daily rhythms[J].Nat Rev Neurosci,2007,8(10):790-802.
[12]Wood PA,Du-Quiton J,You SJ,et al.Circadian clock coordinates cancer cell cycle progression,thymidylate synthase,and 5-fluorouracil therapeutic index[J].Mol Cancer Ther,2006,5(8):2023.
[13]Garufi C,Vanni B,Aschelter AM,et al.Randomised phase II study of standard versus chronomodulated CP-11 plus chromomodulated5 fluorouracil and folinic acid in advanced colorectal cancer patients[J].Eur J Cancer,2006,42(5):608-616.
[14]Granda TG,D Attino RM,Filipski E,et al.Circadian optimization of irinotecan and oxaliplatin efficacy in mice with Glasgow osteosarcoma[J].Br J Cancer,2002,86(6):999-1005.
[15]蔡东焱,张茹霞,吴小红.伊立替康联合氟尿嘧啶时辰化疗在晚期结直肠癌中的应用[J].临床肿瘤学杂志,2010,15(12):1103-1106.
[16]Erbel R,Di Mario C,Bartunek J,et al.Temporary scaffolding of coronary arteries with bioabsorbable magnesium stents:a prospective,non-randomised multicentre trial[J].Lancet,2007,369(9576):1869-1875.
[2]Courtney RJ,Paul CL,Carey ML,et al.A population-based crosssectional study of colorectal cancer scrccning practices of first-degree reatives of colorectal cancer patients[J].BMC Cancer,2013,13(1):13.
[3]许岸高,姜泊,钟旭辉,等.广东地区近20年大肠癌临床特征的变化趋势[J].中华医学杂志,2006,86(4):272-275.
[4]Abolmaali K,Balakrishnan A,et al.Circadian variation in intestinal dihydropyrimidine dehydrogenase(DPD)expression:a potential mechanism for benefits of 5-FU chronochemotherapy[J].Syrgery,2009,146(2):269-273.
[5]范娟,韩云炜,陈枫,等.CPT-11在鼻咽癌裸鼠组织中时辰给药疗效观察及细胞周期分布变化的初步研究[J].中华肿瘤防治杂志,2008,15(9):699-702.
[6]中国抗癌协会癌症康复与姑息治疗专业委员会(CRPC),中国临床肿瘤学会抗肿瘤药物安全管理专家委员会(ASMC).肿瘤治疗相关呕吐防治指南(2014版)[J].临床肿瘤学杂志,2014,19(3):263-273.
[7]张怡,李中东.伊立替康的不良反应及处理[J].中国药物警戒,2006,3(5):271-273.
[8]周际昌,王奇璐.抗肿瘤药物的不良反应与疗效评价[M]//周际昌.实用肿瘤内科学.第2版.北京:人民卫生出版社,2003:29-46.
[9]周兆飞,陆建伟,尹必俭,等.含CPT-11时辰化疗的联合方案治疗晚期恶性肿瘤的临床研究[J].中国肿瘤外科杂志,2009,1(3):144-147.
[10]Xian LJ,Sun J,Cao QY,et al.Circadian rhythms of DNA synthesis in nasopharyngeal carcinoma cells[J].Chronobiol Int,2002,19(1):69-76.
[11]Herzog ED.Neurons and networks in daily rhythms[J].Nat Rev Neurosci,2007,8(10):790-802.
[12]Wood PA,Du-Quiton J,You SJ,et al.Circadian clock coordinates cancer cell cycle progression,thymidylate synthase,and 5-fluorouracil therapeutic index[J].Mol Cancer Ther,2006,5(8):2023.
[13]Garufi C,Vanni B,Aschelter AM,et al.Randomised phase II study of standard versus chronomodulated CP-11 plus chromomodulated5 fluorouracil and folinic acid in advanced colorectal cancer patients[J].Eur J Cancer,2006,42(5):608-616.
[14]Granda TG,D Attino RM,Filipski E,et al.Circadian optimization of irinotecan and oxaliplatin efficacy in mice with Glasgow osteosarcoma[J].Br J Cancer,2002,86(6):999-1005.
[15]蔡东焱,张茹霞,吴小红.伊立替康联合氟尿嘧啶时辰化疗在晚期结直肠癌中的应用[J].临床肿瘤学杂志,2010,15(12):1103-1106.
[16]Erbel R,Di Mario C,Bartunek J,et al.Temporary scaffolding of coronary arteries with bioabsorbable magnesium stents:a prospective,non-randomised multicentre trial[J].Lancet,2007,369(9576):1869-1875.