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首页> 外文期刊>Tumori. >Single-agent irinotecan as second-line weekly chemotherapy in elderly patients with advanced colorectal cancer.
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Single-agent irinotecan as second-line weekly chemotherapy in elderly patients with advanced colorectal cancer.

机译：老年晚期大肠癌患者单药伊立替康作为每周二线化疗。

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AIMS AND BACKGROUND: Irinotecan is a standard option for relapsed/refractory advanced colorectal cancer. Although in a recently reported, randomized trial it was found that a regimen of irinotecan once every 3 weeks was associated with a lower incidence of severe diarrhea than with weekly treatment with similar efficacy, there is no evidence in the literature that suggests the optimal dosing strategy for the drug, along with treatment efficacy and safety, following 5-fluorouracil/oxaliplatin-based chemotherapy in elderly patients. A phase II study has reported significantly reduced toxicity when irinotecan was administered once a week for 2 weeks, followed by a week rest. PATIENTS AND METHODS: From January 2004 to April 2005, we analyzed, retrospectively, our data on single-agent irinotecan as a second-line chemotherapy in elderly patients (> or =70 years) with advanced colorectal cancer. Twenty-three patients were evaluated. CPT-11 (80 mg/m2) was given as a 60-min intravenous infusion in repeated 21-day courses comprising weekly treatment for 2 consecutive weeks followed by a 1-week rest. Tumor measurements were obtained after every third course of therapy. Toxicity was assessed weekly using the National Cancer Institute Common Toxicity Criteria, version 2. RESULTS: The median number of treatment courses received per patient was 4 (range, 1-8). All patients were assessable for toxicity and 21 for response. The most frequently observed severe toxicities were diarrhea (grade 3, 13%) and neutropenia (grade 3, 30.4%; grade 4, 8.6%). Only 1 case of neutropenic fever occurred. Other hematological and non-hematological toxicities were mild and manageable. Objective partial responses were observed in 3 patients (13%). An additional 10 patients (43%) had stable disease as their best response. To date, 12 patients have progressed with a median time-to-progression of 4.3 months and a median survival of 8.3 months. CONCLUSIONS: A weekly irinotecan administration can induce tumor control in elderly patients with advanced colorectal cancer that has progressed during or shortly after 5-fluorouracil/oxaliplatin-based chemotherapy. However, a careful monitoring of hematological toxicity and special instructions to prevent and manage diarrhea are mandatory in this setting of patients.
机译：目的和背景：伊立替康是复发/难治性晚期大肠癌的标准选择。尽管在一项最近报道的随机试验中，发现伊立替康方案每3周一次的严重腹泻发生率比每周一次具有相似疗效的治疗的发生率低，但文献中没有证据表明最佳剂量策略在老年患者中进行基于5氟尿嘧啶/奥沙利铂的化学疗法后，该药物的使用以及治疗效果和安全性。 II期研究报告说，伊立替康每周一次给药2周，然后休息一周，可明显降低毒性。患者与方法：从2004年1月至2005年4月，我们回顾性分析了老年患者（>或= 70岁）单药伊立替康作为二线化疗的数据。评价了23例患者。 CPT-11（80 mg / m2）在连续21天的疗程中以60分钟静脉滴注的方式给药，包括连续2周每周治疗，然后休息1周。每三疗程后获得一次肿瘤测量值。每周使用美国国家癌症研究所通用毒性标准2版评估毒性。结果：每位患者接受的治疗疗程中位数为4（范围为1-8）。所有患者的毒性均可评估，而反应的评估为21。观察到的最严重的严重毒性是腹泻（3级，13％）和中性粒细胞减少（3级，30.4％; 4级，8.6％）。仅发生1例中性粒细胞减少症。其他血液学和非血液学毒性均为轻度且易于控制。在3例患者中观察到客观的部分反应（13％）。另外有10名患者（43％）病情稳定，是他们的最佳反应。迄今为止，已有12例患者进展，中位进展时间为4.3个月，中位生存时间为8.3个月。结论：伊立替康每周给药可诱导老年晚期结直肠癌患者控制肿瘤，该过程已在基于5-氟尿嘧啶/奥沙利铂的化疗期间或之后进展。但是，在这种情况下，必须对血液毒性进行仔细监测，并采取预防和控制腹泻的特殊说明。

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