- 期刊
Efficacy and Safety of Two Different Regimens of Irinotecan for Metastatic Colorectal Cancer: Experience in a Southern Taiwan Medical Center
比較轉移性之大腸直腸癌病患接受兩種不同的Irinotecan化學治療處方的有效性及安全性－單一南台灣醫學中心之經驗
並列摘要
Purpose. This retrospective study evaluates the two different regimens of irinotecan/5-fluorouracil(5-FU)/leucovorin(LV) chemotherapy, comparing the toxicities and the efficacy achieved in Taiwanese patients with metastatic colorectal cancer (mCRC).Methods. Sixty-three patients with mCRC receiving irinotecan-based chemotherapy between January 2002 and December 2007 in Kaohsiung Medical University Hospital were analyzed retrospectively. The patients were divided into two arms according to the different regimens. In arm A (IFL): 30 patients received intravenous (IV) irinotecan (125 mg/m^2 as a 120-min IV infusion) and LV(20 mg/m^2), and then 5-FU (500 mg/m^2 as an IV bolus infusion), weekly for 4 weeks, repeated every 6 weeks. In arm B (FOLFIRI), 33 patients received irinotecan (180 mg/m^2 as a 120-min IV infusion), and LV (400 mg/m^2 IV over 2 hours), and then 5-FU (400 mg/m^2 as an IV bolus infusion followed by 2400 mg/m^2 IV infusion over a 46-hours period), repeated every 2 weeks. The characteristics of each patient, the adverse effects and responses after chemotherapy were recorded.Results. The overall response rate (all partial responses) was 21.4% (6/28) for IFL group and 45.5% (15/33) for FOLFIRI group, with overall disease control rate (partial response plus stable disease) of 53.6% in IFL group and 66.7% in FOLFIRI group. The median time to progression was 5.5 months in IFL group and 6.5 months in FOLFIRI group. There was no statistically significant difference of overall response and progression free survival between the two arms. Of all toxicities recorded, grade 1 allergic reaction was found with the incidence of 10.0% (3/30) for IFL group and 3.0% (1/33) for FOLFIRI group. The incidence of grade 3/4 neutropenia/leukopenia encountered was 10.0% (3/30)/3.3% (1/30) for IFL group and 15.2% (5/33)/ 9.1% (3/33) for FOLFIRI group. Gastrointestinal adverse effects (nausea, vomiting, or diarrhea) were slightly more common in the FOLFIRI group than in the IFL group, however, these were reversible and manageable.Conclusions. Both FOLFIRI and IFL regimen are comparably safe and well-tolerated regimens. We suggested that both regimens could be considered as front-line regimen of irinotecan-based chemotherapy for Taiwanese patients with mCRC.