Second-line chemotherapy with irinotecan plus cisplatin after the failure of S-1 monotherapy for advanced gastric cancer
Second-line chemotherapy with irinotecan plus cisplatin after the failure of S-1 monotherapy for advanced gastric cancer
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DOI：
10.1007/s10120-010-0557-0
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发表时间：
2010-08-01
期刊：
影响因子：
7.4
通讯作者：
Shirao, Kuniaki
中科院分区：
文献类型：
--
作者：
Takahari, Daisuke;Shimada, Yasuhiro;Shirao, Kuniaki
背景对于进展期胃癌（AGC），S-1失败后的二线化疗尚未确立。本研究旨在回顾性评价伊立替康联合顺铂（IP）治疗S-1治疗失败的晚期胃癌患者的疗效和安全性。受试者包括87例接受IP治疗作为二线化疗的AGC患者。伊立替康（70 mg/m2）静脉输注给药，然后在第1天静脉输注顺铂（80 mg/m2）。第15天，伊立替康（70 mg/m2）单独给药。治疗每4周重复一次，直至疾病进展、患者拒绝或出现严重不良事件。中位患者年龄为62岁（范围：39-75岁），中位治疗周期数为3（范围：1-9）。在87例患者中，70例可评估临床应答。完全缓解2例，部分缓解18例。总有效率为28.6%（95%可信区间[CI]，18.4%-40.6%），疾病控制率为70.0%。从IP治疗第一天开始的中位至进展时间和中位生存时间分别为4.3个月和9.4个月。1年生存率为34.6%。分别在34%、40%、28%和8%的患者中观察到重度（34级）白细胞减少、中性粒细胞减少、贫血和血小板减少。3/4级非血液学毒性包括厌食（17%）、发热性中性粒细胞减少（10%）、腹泻（6%）、疲乏（5%）、恶心（2%）和肌酐升高（1%）。伊立替康联合顺铂作为AGC的二线化疗似乎是S-1治疗失败后的一种有效可行的治疗选择。
Background. For advanced gastric cancer (AGC), second-line chemotherapy after the failure of S-1 has not yet been established. The present study aimed to retrospectively evaluate the efficacy and safety of irinotecan plus cisplatin (IP) therapy after the failure of S-1 in patients with AGC.Methods. The subjects included 87 patients with AGC who received IP therapy as second-line chemotherapy. Irinotecan (70 mg/m(2)) was administered by intravenous infusion followed by an intravenous infusion of cisplatin (80 mg/m(2)) on day 1. On day 15, irinotecan (70 mg/m(2)) alone was administered. The treatment was repeated every 4 weeks until disease progression, patient refusal, or severe adverse events.Results. The median patient age was 62 years (range, 39-75 years), and the median number of treatment cycles was 3 (range, 1-9). Out of the 87 patients, 70 were assessable for clinical response. There were 2 complete responses and 18 partial responses. The overall response rate was 28.6% (95% confidence interval [CI], 18.4%-40.6%) and the disease control ratio was 70.0%. The median time to progression and median survival time from the first day of IP therapy were 4.3 months and 9.4 months, respectively. The 1-year survival rate was 34.6%. Severe (grade 3/4) leukopenia, neutropenia, anemia, and thrombocytopenia were observed in 34%, 40%, 28%, and 8% of patients, respectively. Grade 3/4 nonhematologic toxicities included anorexia (17%), febrile neutropenia (10%), diarrhea (6%), fatigue (5%), nausea (2%), and elevated creatinine (1%).Conclusions. The combination of irinotecan plus cisplatin as second-line chemotherapy for AGC appears to be an effective and feasible treatment option after S-1 failure.