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目的评价改良的FOLFIRI(mFOLFIRI)方案用于奥沙利铂和氟尿嘧啶类药物治疗失败的晚期结直肠癌的疗效和安全性。方法对奥沙利铂和氟尿嘧啶类药物治疗失败的83例晚期结直肠癌患者,采用mFOLFIRI方案治疗。伊立替康180 mg／m2,静脉滴注90 min,第1天;甲酰四氢叶酸(LV)200 mg/m2,静脉滴注2 h,第1天;5-氟尿嘧啶(5-Fu)400 mg／m2,静脉推注,第1天;5-Fu 2．4 g/m2,静脉滴注46 h(泵);每14天重复。观察疗效和不良反应。结果80例可评价疗效患者中,部分缓解(PR)10例(12．5％),稳定(SD)51例(63．7％),疾病进展(PD)19例(23．8％)。中位至疾病进展时间96 d。83例患者可评价安全性。最常见的Ⅲ、Ⅳ度毒性是中性粒细胞减少(24．1％)、恶心、呕吐(8．4％)和延迟性腹泻(2．4％)。结论mFOLFTRI方案应用于奥沙利铂和氟尿嘧啶类药物治疗失败的晚期结直肠癌安全有效。
Objective To evaluate the efficacy and safety of a modified FOLFIRI (mFOLFIRI) regimen for the treatment of advanced colorectal cancer with failed oxaliplatin and fluorouracil therapy. Methods Eighty-three patients with advanced colorectal cancer who failed oxaliplatin and fluorouracil therapy were treated with the mFOLFIRI regimen. Irinotecan 180 mg / m2, intravenous infusion of 90 min, the first day; leucovorin (LV) 200 mg / m2, intravenous infusion of 2 h, the first day; 5-fluorouracil mg / m2, intravenous bolus, Day 1; 5-Fu 2.4 g / m2, intravenous infusion 46 h (pump); repeated every 14 days. To observe the efficacy and adverse reactions. Results Among 80 evaluable patients, partial remission (PR) occurred in 10 cases (12.5%), stable (SD) in 51 cases (63.7%) and disease progression (PD) in 19 cases (23.8%). The median time to disease progression 96 d. Eighty-three patients were evaluated for safety. The most common grade III and IV toxicities were neutropenia (24.1%), nausea, vomiting (8.4%) and delayed diarrhea (2.4%). Conclusion The mFOLFTRI regimen is safe and effective in the treatment of advanced colorectal cancer with failed oxaliplatin and fluorouracil therapy.