Gastric cancer is one of the common malignant tumors. The incidence is approximately 400,000 in China every year.
And the death number is about 300,000. Chemotherapy is the main treating method for advanced gastric cancer. Most patients with advanced gastric cancer get improved after the first-line chemotherapy. Therefore, to explore the safe and effective second-line chemotherapy in the treatment of advanced gastric cancer have important clinical significance. The joint application of irinotecan based regimen achieves a good effect in advanced gastric cancer.
CBR to evaluate a clinical indicator of refractory tumors, including gastrointestinal tumors, including in recent years, including pain scores or analgesic amount, KPS score and weight gain three indicators, one, two other stable effective, all three stabilizer for a stable, an invalid is invalid. The preferred method of treatment of gastric cancer is radical surgery, but about 40% of patients diagnosed at an advanced stage, systemic chemotherapy is superior to best supportive care in the treatment of advanced gastric cancer have now been finalized. But for advanced gastric cancer is currently no standardized clinical treatment programs. Clinical research suggests that better survival benefit in patients receiving second-line and above chemotherapy.
Irinotecan is a camptothecin derivative from specific topoisomerase I inhibitor. Topoisomerase I is a key enzyme in DNA replication, the formation of complexes of irinotecan health and topoisomerase I and DNA bind strongly to prevent topoisomerase I to repair DNA breaks caused by DNA irreversible fracture, to the anti-tumor effect. The irinotecan Cornell single-agent treatment of gastric cancer was 18% to 23%. The study confirms the status of irinotecan in first-line chemotherapy in advanced gastric cancer. Used the DDP in advanced gastric cancer, using Iraq irinotecan joint LV/5-FU second-line treatment of first-line irinotecan combined with DDP second-line treatment of first-line is not used in the DDP in advanced gastric cancer. The total efficiency is about 24%.
Irinotecan‘s main adverse reactions are hair loss, delayed diarrhea, neutropenia and acute cholinergic syndrome according to reminds of pharmaceutical raw materials suppliers. Delayed diarrhea is diarrhea that occurs after administration of 24 h, the occurrence rate of 24%. Inform patients of the chemotherapy should be preceded by, and I loperamide spare patients loose stools verdict, symptomatic treatment can effectively control diarrhea; neutropenia is also the irinotecan the Kang dose-limiting toxicity is one of, III / IV neutropenia was 32%, it should be closely monitored during chemotherapy hemogram, if necessary, to G-CSF support. c degree of neutropenia to actively support the treatment of neutrophils returned to normal; acute cholinergic syndrome is due to the inhibition of acetylcholinesterase irinotecan show cholinergic role and performance of early-onset diarrhea. trembling, salivation, vomiting, miosis, etc. The incidence of acute cholinergic syndrome is 32%.
Once the acute cholinergic syndrome occurs, the use of atropine with subcutaneous injection can make the symptoms disappeared. For the patients with acute cholinergic syndrome in past, the prophylactic atropine will avoid its occurrence. In short, the second-line irinotecan-based chemotherapy can extend overall survival of advanced gastric cancer patients. It has high disease control rate and it is safe. The adverse reactions can be controlled and it is worth further clinical verification.
Source:http://www.cospcn.com
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