Effects of irinotecan combined with tegafur and mFOLFIRI second-line chemotherapy on patients with advanced gastric cancer

Ma Lihua; Qian Yiyin; Fu Wei; Xia Kaijian; Lu Xiao

doi:10.3760/j.issn.1673-4777.2019.01.019

Abstract：Objective To investigate the effects of irinotecan combined with tegafur and mFOLFIRI second-line chemotherapy on patients with advanced gastric cancer.Methods From May 2014 to December 2016,58 patients with advanced gastric cancer who failed in first-line chemotherapy were enrolled at Changshu No.1 People's Hospital.They were randomly divided into control group(n =31) and observation group(n =27).The observation group was treated with irinotecan plus tegafur second-line chemotherapy;1 course was 21 d;the efficacy was assessed according to Response Evaluation Criteria in Solid Tumors after 2 courses of therapy.The control group had mFOLFIRI second-line chemotherapy (irinotecan + calcium folinate + 5-fluorouracil);1 cycle was 14 d;1 course was 2 circles;the efficacy was assessed after 3 circles.Progression free survival(PFS),overall survival(OS) and adverse reactions were analyzed.Results Disease progression rate in the observation group was lower than that in the control group [33.3 ％ (9/27) vs 45.2％ (14/31)] (P ＜ 0.05).Disease control rate in the observation group was higher than that in the control group[66.7％ (18/27) vs 54.8％ (17/31)] (P ＜0.05).PFS time was 1.4-8.2 months in the observation group and 1.4-7.6 months in the control group was;the median PFS time was 4.2 and 3.5 months respectively;there was a significant difference between the two groups (P =0.026).OS showed no significant difference between the two groups(P =0.456).Incidences of grade]Ⅲ-Ⅳ leukopenia and neutropenia in the observation group were lower than those in the control group;incidences of grade Ⅰ-Ⅳ anemia,vomiting,fatigue and mucositis in the observation group were lower than those in the control group (all P ＜ 0.05).Conclusions Compared with mFOLFIRI regimen,irinotecan plus tegafur second-line chemotherapyis more effective in improving disease control rate and PFS with less adverse reaction and better tolerance;it shows no positive effect on the total therapeutic rate and OS.