伊立替康联合环磷酰胺治疗晚期神经母细胞瘤疗效观察

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1974 KB) RICH HTML
输出: BibTeX | EndNote (RIS)

摘要目的探讨含伊立替康联合环磷酰胺方案对晚期神经母细胞瘤(neuroblastoma ，NB)患者的临床疗效及安全性。方法回顾性总结分析武警总医院儿科自2008-05至2015-09收治的采用含伊立替康联合环磷酰胺方案(观察组)治疗的18例晚期神经母细胞患者临床资料，并与采用未含伊立替康联合环磷酰胺方案(对照组)治疗的18例晚期NB患儿进行比较，分析并总结伊立替康联合环磷酰胺治疗晚期NB临床疗效和安全性。结果至2015-09-30，(1)疾病总有效率观察组(55.6%)高于对照组(27.8%)，差异无统计学意义;疾病总控制率观察组(77.8%)高于对照组(38.9%)，差异有统计学意义(P<0.05);(2)中位无进展生存期、中位总生存期观察组(31个月，28个月)较对照组高(15个月，17个月)，差异有统计学意义(P＜0.05);(3)随访时间达1年患者，观察组15例，对照组18例，1年生存率观察组(100%)高于对照组(61.1%)，差异有统计学意义(P＜0.05);(4)用药期间不良事件主要包括恶心、呕吐等消化道症状及骨髓抑制相关的血液学毒性，观察组发生血小板下降、贫血、转氨酶增高较对照组少。结论伊立替康联合环磷酰胺用于治疗晚期神经母细胞瘤，疗效肯定，且未发生严重的毒副反应。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	杜旭艳
	苗丽霞
	孙岩峰
	李彦珊
	袁海莲
	刘秋玲

关键词 ：神经母细胞瘤, 伊立替康, 环磷酰胺, 疗效, 安全性

Abstract：Objective To study the clinical efficacy of irinotecan plus cyclophosphamide in children with advanced neuroblastoma (NB).Methods We summarized clinical data of 18 children with advanced neuroblastoma who were treated with irinotecan plus cyclophosphamide (observation group) between May 2008 to September 2015 in the General Hospital of Peoples Armed Forces. Another 18 cases with advanced neuroblastoma received non irinotecan plus cyclophosphamide chemotherapy were employed as control group.The efficacy and safety were reviewed.Results As of September 30,2015, The disease control rate in observation group(55.56%)was higher than that in control group(27.8%); The responsive rate in observation group (77.78%) was higher than that in control group (38.9%).The progression-free survival and overall survival of observation group (31 months,28 months) was higher than that in control group(15 months,17 months)(P<0.05).In the observation group, 15 cases were followed up for 1 year, 18 cases in the control group were followed up for 1 year. The 1 year survival rate in the observation group (100%) was higher than that in the control group (61.1%,P<0.05). The dose-limiting toxicity(DLT) included nausea, vomiting, diarrhea and other gastrointestinal symptoms and bone marrow suppression of hematology toxicity. Thrombocytopenia, anemia, elevated aminotransferase in control group were higher than that in the observation group (P<0.05).Conclusions Irinotecan combined with cyclophosphamide used for treatment of advanced NB has certain curative effects without extra side effects.

Key words： neuroblastoma irinotecan cyclophosphamide curative effect safety

收稿日期: 2015-11-22

ZTFLH:

R453.9

通讯作者: 刘秋玲,E-mail:wj670@vip.sina.com

作者简介: 杜旭艳，硕士研究生。

引用本文:

杜旭艳，苗丽霞，孙岩峰，李彦珊，袁海莲，刘秋玲. 伊立替康联合环磷酰胺治疗晚期神经母细胞瘤疗效观察[J]. 武警医学, 2016, 27(7): 714-718. DU Xuyan, MIAO Lixia, SUN Yanfeng, LI Yanshan, YUAN Hailian, and LIU Qiuling. A clinical study of irinotecan plus cyclophosphamide for advanced neuroblastoma. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(7): 714-718.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2016/V27/I7/714

[1]	Haupt R, Garaventa A C, Parodi S, et al. Improved survival of children with neuroblastoma between 1979 and 2005: a report of the Italian Neuroblastoma Registry[J]. J Clin Oncol,2010,28(14):2331-8.
[2]	Adeline S, Dhanya M, Barry P, et al.Neuroblastoma: a 20-year experience in a UK regional centre[J]. Pediatric Blood Cancer,2011,57(7):1254-1260.
[3]	张信平. 转移性结肠癌药物治疗的研究进展[J].中国新药与临床杂志,2007,26(11):868-872.
[4]	Hegde S R, Weijing S, Lynch J P. Systemic and targeted therapy for advanced colon cancer[J]. Expert Rev Gastroenterol Hepatol, 2014,2(1):135-49.
[5]	张贺龙. 实体瘤疗效评价标准及演变[J]. 现代肿瘤医学,2010,05(05):839-841.
[6]	Mcbride D. Immunotherapy improves survival for patients with neuroblastoma[J]. Ons Connect,2009, 24(8):17.
[7]	Castel V, Segura V, Canete A. Treatment of high-risk neuroblastoma with anti-GD2 antibodies[J]. Clin Transl Oncol,2010,12(12):788-93.
[8]	Simon T, Hero B, Faldum A, et al. Long term outcome of high-risk neuroblastoma patients after immunotherapy with antibody ch14.18 or oral metronomic chemotherapy[J]. Bmc Cancer,2011,11(1):1-8.
[9]	杨婷, 胡显良, 王珊. 神经母细胞瘤治疗进展[J]. 中国小儿血液与肿瘤杂志, 2015, 20(6):329-332.
[10]	Ruth H, Angelika E, Tomoro H, et al. Resistance to Chemotherapy Mediated by TrkB in Neuroblastomas[J]. Cancer Res,2002,62(22):6462-6466.
[11]	McWilliams N B,Hayes F A,Green A A,et al. Cyclophosphamide /doxorubicin vs. cisplatin /teniposide in the treatment of children older than 12 months of age with disseminated neuroblastoma: a Pediatric Oncology Group Randomized Phase II study[J]. Med Pediatr Oncol,1995,24( 3):176-180.
[12]	Wagner L M, Villablanca J G, Stewart C F, et al. Phase I trial of oral irinotecan and temozolomide for children with relapsed high-risk neuroblastoma: a new approach to neuroblastoma therapy consortium study[J]. J Clin Oncol,2009,27(8):1290-1296.
[13]	Pourquier P, Waltman J L, Urasaki Y, et al. Topoisomerase I-mediated cytotoxicity of N-methyl-N’-nitro-N-nitrosoguanidine: trapping of topoisomerase I by the O6-methylguanine[J]. Cancer Res,2001,61(1):53-58.
[14]	Wagner L M, Crews K R, Iacono L C, et al. Phase I trial of temozolomide and protracted irinotecan in pediatric patients with refractory solid tumors[J].Clin Cancer Res,2004,10(3):840-848.
[15]	Wagner L M, Nancy McAllister M D, Goldsby R E, et al. Temozolomide and intravenous irinotecan for treatment of advanced Ewing sarcoma[J].Pediatric Blood Cancer,2007,48(2):132–139.
[16]	Houghton P J, Stewart C F, Cheshire P J, et al. Antitumor activity of temozolomide combined with irinotecan is partly independent of O6-methylguanine-DNA methyltransferase and mismatch repair phenotypes in xenograft models[J]. Clin Cancer Res,2000,6(10):4110-4118.
[17]	Turner C D, Gururangan S, Eastwood J, et al. Phase II study of irinotecan (CPT-11) in children with high-risk malignant brain tumors: the Duke experience[J]. Neuro Oncol,2002,4(2):102-108.
[18]	Wolfgang W, Michael W. How lymphotoxic is dose-intensified temozolomide? The glioblastoma experience[J]. J Clin Oncol, 2005,23(18):4235-42367.
[19]	Kuo D J, Weiner H L, Jeffrey W, et al. Temozolomide is Active in Childhood, Progressive, Unresectable, Low-Grade Gliomas[J]. J Pediatr Hematol Oncol,2003,25(5):372-378.
[20]	Kushner B H, Kim K, Shakeel M, et al. Irinotecan plus temozolomide for relapsed or refractory neuroblastoma[J]. J Clin Oncol,2006,24(33):5271-5276.