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目的观察CPT-11(开普拓)联合5-FU/CF治疗晚期结直肠癌的临床疗效和毒副反应。方法入组患者27例均为手术后局部复发和转移的晚期结直肠癌,经FOLFIRI方案化疗二个疗程(共4次)后,评价疗效,按照WHO实体瘤近期客观疗效评定标准进行评价。结果全组27例均可评价疗效及不良反应。完全缓解(CR)为0,部分缓解(PR)为6例(6/27),总有效率(CR+PR)达22%,疾病稳定(SD)16例(16/27)59.26%,疾病控制率(CR+PR+SD)为81.48%,疾病进展(PD)5例(5/27)18.52%。中位疾病进展时间为7.1个月(5～26个月),中位生存时间9.2个月。不良反应主要是消化道反应和骨髓抑制,以延迟性腹泻为多见,有8例为Ⅰ/Ⅱ度,Ⅲ/Ⅳ度仅1例,有4例Ⅰ/Ⅱ度骨髓抑制,Ⅲ/Ⅳ度骨髓抑制仅2例,无治疗相关的死亡。结论开普拓联合5-FU/CF治疗晚期结直肠癌近期疗效确切,不良反应可控制,临床上可大胆应用。
Objective To observe the clinical efficacy and adverse reactions of CPT-11 (CAPT) combined with 5-FU / CF in the treatment of advanced colorectal cancer. Methods Twenty-seven patients with advanced colorectal cancer who had local recurrence and metastasis after operation were evaluated by two courses of FOLFIRI chemotherapy (total 4 times), and the curative effect was evaluated according to the objective curative effect of WHO solid tumor in the near future. Results The whole group of 27 patients can evaluate the efficacy and adverse reactions. CR was 0, partial response (PR) was 6 cases (6/27), total effective rate (CR + PR) was 22%, stable disease (SD) was 16 (16/27) 59.26% Control rate (CR + PR + SD) was 81.48%, disease progression (PD) 5 cases (5/27) 18.52%. The median time to progression was 7.1 months (range 5 to 26 months) with a median survival of 9.2 months. Adverse reactions were mainly gastrointestinal reactions and myelosuppression, with delayed diarrhea as the more common, there are 8 cases of Ⅰ / Ⅱ degree, Ⅲ / Ⅳ degree in only 1 case, 4 cases of Ⅰ / Ⅱ degree myelosuppression, Ⅲ / Ⅳ degree Myelosuppression only 2 cases, no treatment-related deaths. Conclusions Capetrop combined with 5-FU / CF is effective in the treatment of advanced colorectal cancer in the near future. Adverse reactions can be controlled and can be used clinically.