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和不良反应。方法收集我院2015年9月至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和常规化疗组(各组40人),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。结果对比常规化疗组,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常规化疗组(P<0.05),而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略优于常规化疗,但主要毒副作用显著减轻,可作为复发转移性结直肠癌治疗的替代方案。
Objective To explore the short-term effects and toxicities of chronochemotherapy compared with conventional chemotherapy with FOLFIRI regimen for patients with recurrent and/or metastatic colorectal cancer. Methods From September 2015 to September 2017, 80 patients with recurrent and/or metastatic colorectal cancer were prospectively collected. All patients undergoing chemotherapy with FOLFIRI regimen were randomly divided into chronochemotherapy group(40 patients) and conventional chemotherapy group(40 patients). The effective rate, disease control rate and incidence of main adverse reaction were evaluated. Results As compared with conventional chemotherapy group, the effective rate and disease control rate in chronochemotherapy group were improved, but there were no significant differences. Besides, the incidence of leucopenia and neutropenia, anemia, nausea and vomiting were significantly decreased(P <0.05),with no significant difference observed for other main adverse reactions. Conclusions Chronochemotherapy with FOLFIRI regimen has better short-term effects, with decreased incidence of main adverse reaction compared to conventional chemotherapy. As a result, it can be an optimal replacement measure for such patients
Objective To explore the short-term effects and toxicities of chronochemotherapy compared with conventional chemotherapy with FOLFIRI regimen for patients with recurrent and/or metastatic colorectal cancer. Methods From September 2015 to September 2017, 80 patients with recurrent and/or metastatic colorectal cancer were prospectively collected. All patients undergoing chemotherapy with FOLFIRI regimen were randomly divided into chronochemotherapy group(40 patients) and conventional chemotherapy group(40 patients). The effective rate, disease control rate and incidence of main adverse reaction were evaluated. Results As compared with conventional chemotherapy group, the effective rate and disease control rate in chronochemotherapy group were improved, but there were no significant differences. Besides, the incidence of leucopenia and neutropenia, anemia, nausea and vomiting were significantly decreased(P <0.05),with no significant difference observed for other main adverse reactions. Conclusions Chronochemotherapy with FOLFIRI regimen has better short-term effects, with decreased incidence of main adverse reaction compared to conventional chemotherapy. As a result, it can be an optimal replacement measure for such patients
引文
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[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 cross-sectional study of colorectal cancer screening practices of first-degree relatives of colorectal cancer patients[J].BMC Cancer,2013,10(13):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(4):272-275.
[4]Abolmaali K,Balakrishnan A,Stearns AT,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[A].周际昌.实用肿瘤内科学[C].2版.北京:人民卫生出版社有限公司,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,and5-fluorouracil therapeutic index[J].Mol Cancer Ther,2006,5(8):2023-2033.
[13]Garufi C,Vanni B,Aschelter AM,et al.Randomised phase II study of standard versus chronomodulated CP-11 plus chromomodulated 5 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.