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find Keyword "伊立替康" 7 results
  • Capecitabine Combined with Irinotecan for Metastatic Colorectal Cancer: A Meta Analysis

    目的 评价卡培他滨+伊立替康与氟尿嘧啶/醛氢叶酸(5-FU/LV)+伊立替康治疗转移性结直肠癌的有效性和安全性。 方法 计算机检索PubMed、CENTRAL、Embase、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库,检索时间均从建库至2011年9月。对符合纳入标准的随机对照试验进行质量评价和Meta分析。 结果 纳入3个随机对照试验,共计419例患者,卡培他滨+伊立替康在中位生存期、完全缓解率[RR=1.58,95%CI(0.27,9.11),P=0.61]、部分缓解率[RR=0.86,95%CI(0.68,1.09),P=0.20]、总有效率[RR=0.88,95%CI(0.71,1.09),P=0.26]上表现出与5-FU/LV+伊立替康相似的效果,安全性方面卡培他滨+伊立替康有较高的Ⅲ/Ⅳ级恶心[RR=1.92,95%CI(1.05,3.54),P=0.04]、腹泻[RR=3.23,95%CI(2.14,4.89),P<0.000 01]发生风险和较低的Ⅲ/Ⅳ级中性粒细胞减少[RR=0.72,95%CI(0.53,0.98),P=0.04]发生风险。 结论 根据当前现有证据,5-FU/LV+伊立替康可能较卡培他滨+伊立替康更为有利于转移性结直肠癌患者的治疗,但仍需结合临床实际情况进行化疗方案的优选。

    Release date:2016-09-08 09:14 Export PDF Favorites Scan
  • 卡培他滨在结直肠癌中单用与联用的应用现状

    卡培他滨是结直肠癌化学治疗(化疗)方面较好的药物,在安全性和有效性等方面都显示了一定程度的优越性。其单用效果较好,使用后不良反应发生率低,有希望取代氟尿嘧啶;与奥沙利铂联用有较为满意的疗效,但其与伊立替康联用效果有待进一步研究。由于患者的个体差异,具体化疗方案的选择应根据患者情况而定。现对卡培他滨在结直肠癌化疗中单用与联用的应用现状作一综述,以指导结直肠癌化疗方案的选择。

    Release date:2016-09-08 09:13 Export PDF Favorites Scan
  • A Meta-analysis of Capacitance Combined with Irinotecan versus Fluorouracil Combined with Irinotecan for Advanced Metastatic Colorectal Cancer

    ObjectiveTo assess the effectiveness and safety of capacitance combined with irinotecan (CAPIRI) versus fluorouracil combined with irinotecan (FOLFIRI) for patients with advanced metastatic colorectal cancer. MethodsDatabases such as Pubmed, Embase, Wanfang data, CNKI, Cochran Library were searched from January 2000 to October 2015. We evaluated the quality of randomized controlled trials (RCTs) and then extracted data from them. RevMan 5.2 software was used to perform the meta-analysis. ResultsEight RCTs studies with 1 634 advanced metastatic colorectal cancer patients were included based on our standard. CAPIRI regimen was equal to FOLFIRI regimen in complete response rate [RR=1.17, 95%CI (0.70, 1.96), P=0.56], overall respond rate [RR=0.90, 95%CI (0.79, 1.03), P=0.12], disease control rate [RR=0.93, 95%CI (0.87, 1.00), P=0.06], median progression-free survival [HR=1.00, 95%CI (0.72, 1.37), P=0.99], and median overall survival [HR=0.94, 95%CI (0.63, 1.40), P=0.77]. For safety, higher incidence rate of grade 3/4 vomiting [RR=1.91, 95%CI (1.13, 3.22), P=0.02], diarrhea [RR=2.84, 95%CI (2.22, 3.63), P<0.000 01], hand-foot syndrome [RR=4.55, 95%CI (2.15, 9.61), P<0.000 1] were confirmed for CAPIRI. The two methods had similar toxicities: nausea [RR=0.77, 95%CI (0.64, 0.93), P=0.005], fatigue [RR=1.19, 95%CI (0.73, 1.94), P=0.47], febrile neutropenia [RR=1.59, 95%CI (0.89, 2.87), P=0.12], anemia [RR=1.74, 95%CI (0.59, 5.18), P=0.32], and leukopenia [RR=0.77, 95%CI (0.64, 0.93), P=0.005]. ConclusionCapecitabine combined with irinotecan treatment for advanced colorectal cancer is effective and its toxicity is acceptable.

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  • 奥沙利铂或伊立替康联合氟尿嘧啶类药物一线治疗k-ras突变型晚期结直肠癌的疗效分析

    目的分析奥沙利铂或伊立替康联合氟尿嘧啶类药物一线化学治疗(化疗)k-ras 突变型晚期结直肠癌的疗效和安全性。 方法收集2008年1月-2014年2月收治、经病理确诊的74例k-ras 基因突变型晚期结直肠癌患者,分别使用奥沙利铂(50例)85 mg/m2 第1天或伊立替康(24例)180 mg/m2 第1天,联合氟尿嘧啶(5-Fu)400 mg/m2 静脉推注第1天+5-Fu 2 400 mg/m2 持续静脉滴注46 h +亚叶酸钙400 mg/m2 第1天,14 d 为1个周期或口服卡培他滨1.0 g/m2,2次/d,第1~14天,21 d 为1个疗程。 结果74例患者可评价疗效,奥沙利铂组和伊立替康组的有效率分别为20.0%和12.5%,疾病控制率分别为80.0%和83.3%,中位无进展生存时间分别为8.0个月[95%CI(6.0,10.0个月)和6.7个月[95%CI(6.2,7.2)个月],两组间差异均无统计学意义(P>0.05)。两组患者不良反应易耐受,主要为骨髓抑制和胃肠道反应。 结论k-ras 基因突变型晚期结直肠癌患者,在一线化疗方面奥沙利铂方案较伊立替康方案能获得更高的有效率,同时在晚期结直肠癌的治疗中,检测k-ras 基因的状态不仅在抗EGFR 靶向治疗中有着重要的意义,对于一线化疗方案的选择也有着指导价值。

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  • Relationship between UGT1A1 Polymorphisms and Adverse Effects of Irinotecan in Patients with Esophageal Carcinoma

    ObjectiveTo investigate the distribution of uridine diphosphate-glucuronosyltransferase 1A1 (UGT1A1) gene polymorphisms in esophageal carcinoma (EC) patients, and their relationship with adverse effects (delayed diarrhea and neutropenia) of Irinotecan. MethodsForty-eight patients with esophageal squamous carcinoma who were admitted to Sichuan Provincial People's Hospital between January and October 2012 were recruited in the study. There were 37 male and 11 female patients with their age of 56 (25-38) years. Formalin-fixed, paraffin-embedded samples were collected from those EC patients and genomic DNA was extracted. UGT1A1 polymorphisms were detected by PCR and DNA sequencing. Three genetic loci were investigated including UGT1A1* 28 (TA6 > TA7), UGT1A1* 6 (211G > A) and UGT1A1* 93 (-3156G > A). Adverse effects (delayed diarrhea and neutropenia) of patients with different UGT1A1 polymorphisms after Irinotecan treatment were recorded. The relationship between UGT1A1 polymorphisms and Irinotecan-induced adverse effects was analyzed. ResultsUGT1A1 polymorphisms were detected in 10 out of 48 (20.8%) EC patients. UGT1A1* 93 (-3156G > A)polymorphisms were most common with the polymorphism rate of 16.7% (8/48), followed by GT1A1* 6 (211G > A) polymorphisms with the polymorphism rate of 4.2% (2/48). The incidences of grade 3~4 diarrhea and grade 3~4 neutropenia after Irinotecan treatment in the patients with UGT1A1 polymorphisms were 60.0% and 40.0% respectively, which were significantly higher than those of the patients with wild type UGT1A1 (21.1% and 15.8% respectively, P < 0.05). UGT1A1 polymorphism rates were 45.5% (5/11) in female patients and 13.5% (5/37) in male patients, which were significantly different (P < 0.05). ConclusionsIn EC patients, 2 polymorphism loci including UGT1A1* 93 (-3156G > A) and GT1A1* 6 (211G > A) can effectively predict adverse effects caused by Irinotecan treatment. UGT1A1 polymorphism rate of male patients is significantly lower than that of female patients.

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  • Efficacy and Safety of Irinotecan as Neoadjuvant Chemotherapy for Cervical Cancer: A Meta-analysis

    ObjectiveTo systematically review the efficacy and safety of irinotecan as neoadjuvant chemotherapy (INAC) plus radical surgery (RS) for cervical cancer. MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2014), CBM, CNKI, VIP and WanFang Data to collect clinical studies on INAC plus RS versus RS alone or other neoadjuvant chemotherapy drugs plus RS in the treatment of cervical cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 6 studies (4 RCTs and 2 CCTs) involving 596 patients were included. The results of meta-analysis showed that, compared with the RS alone group, the INAC group was superior in reducing operation time (MD=-16.17, 95%CI -21.88 to -10.46, P<0.000 01), intraoperative blood loss (MD=-39.56, 95%CI -51.96 to -27.17, P<0.000 01), increasing 3-years OS (OR=0.29, 95%CI 0.15 to 0.57, P<0.000 3), reducing incidence of positive parametrical involvement (OR=0.27, 95%CI 0.12 to 0.60, P=0.001) and incidence of lymphovascular space invasion (OR=0.24, 95%CI 0.09 to 0.61, P=0.003). However, there were no significant differences in the incidence of lymph node metastasis (OR=0.55, 95%CI 0.29 to 1.03, P=0.06) and positive surgical margin (OR=0.33, 95%CI 0.03 to 3.86, P=0.38) between the two groups. Compared with the paclitaxel plus RS group, there were no significant differences for the INAC group in the effective rate (OR=1.58, 95%CI 0.20 to 12.32, P=0.66) and the incidence of more than grade Ⅲ adverse events (OR=2.27, 95%CI 0.62 to 8.27, P=0.21). ConclusionINAC is effective and tolerable in the treatment of cervical cancer. Due to the limitation of quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.

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  • Efficacy and safety of capecitabine combined with irinotecan versus capecitabine combined with oxaliplatin in treatment of advanced/metastatic colorectal cancer: a systematic review

    ObjectiveTo systematically review the efficacy and safety of capecitabine combined with irinotecan (CAPIRI) versus capecitabine combined with oxaliplatin (CAPOX) for patients with advanced/metastatic colorectal cancer.MethodsPubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on CAPIRI versus CAPOX for patients with advanced/metastatic colorectal cancer from inception to August 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 12 RCTs involving 1 049 patients were included. The results of meta-analysis showed that: there were no significant differences in complete response (CR), partial response (PR), stable disease (SD), progression disease (PD), overall respond rate (ORR), median progression-free survival (mPFS), and median overall survival (mOS) between two groups (P>0.05). However, CARIRI group was lower on the disease control rate (RR=0.93, 95%CI 0.86 to 1.00, P=0.04) than CAPOX group. Incidence of diarrhea was higher in CAPIRI group (RR=1.83, 95%CI 1.37 to 2.45, P<0.000 1). However, the incidence rate of peripheral neurotoxicity in CAPOX group was higher (RR=0.13, 95%CI 0.05 to 0.35, P<0.000 1). There were no significant differences between two groups in the incidence rates of nausea and vomiting, hand-foot syndrome, anemia, thrombocytopenia, leukocytopenia and alopecia (P>0.05).ConclusionsCurrent evidence shows that two groups are equivalent in terms of curative effects. CAPIRI has a higher incidence rate of diarrhea, while CAPOX has a higher risk of peripheral neurotoxicity. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

    Release date:2019-03-21 10:45 Export PDF Favorites Scan
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