The Observation Of The Efficacy And Adverse Reaction Of The Combination Chemotherapy Of Irinotecan Plus Folinic Acid/Continuous5-fluorouracil Regimen In Treating Advanced Colorectal Adenocarcinoma

Background and purpose：Colorectal cancer is one of the common malignant tumor， In our countrydisease accounted for about10%-15%of all cancer，The fifth of cancer death inChina。In recent years irinotecan joint5-fluorouracil and leucovorin calciumsolution (FOLFIRI) treatment of advanced colorectal cancer curative effect isdistinct. This study aims to discuss the irinotecan joint5-fluorouracil andleucovorin calcium solution the adverse reactions and effects in treatment ofadvanced colorectal cancer，Study UGT1A1*28and UGT1A1*6genotypepolymorphism with Iraq on behalf of irinotecan joint5-fluorouracil and leucovorincalcium olution the side effects of treatment for patients with advanced colorectalcancer and the relationship between the curative effect。Methods:Select from September2011to December2013Second Hospital of JilinUniversity26cases of pathologically confirmed advanced colorectal cancer wereenrolled. Extract26whole blood samples of patients, blood samples extracted DNA,the gene was amplified by PCR fragments, direct sequencing analysis of thedistribution of the26patients with UGT1A1*28and UGT1A1*6genepolymorphism, into the group All patients received FOLFIRI chemotherapy regimen,and treatment time was more than two weeks. To appear in court duringchemotherapy in patients with side effects and curative effect observation and record, more than three degrees difference in the incidence of side effects in patientscomparing the efficacy of different genotypes in the use of FOLFIRI chemotherapyregimen and appear.Results:26cases ofpatients withadvanced colorectal cancer, UGT1A1*6pointswild-typeG/G21patients(80.8%), heterozygousmutantG/A5patients(19.2%),homozygousA/A0cases.UGT1A1*28pointswildtypehaveTA6/6in18cases(69.2%),heterozygousmutantTA6/7,8cases (30.8%), homozygousmutantTA7/70cases.Thewhole group of26patientsare able toevaluatethe efficacyandadverse reactions. Therewere nocomplete remission(CR),partial response(PR)5cases (19.2%), stable (SD)16patients (61.5%).The total effective rate(CR+PR)19.2%,the disease controlratewas(CR+PR+SD)80.7%.Fivepatients hadgrade Ⅲdelayed diarrhea,6patientscheck bloodreturnsappearmorewhite blood cells or degreeⅢneutropenia.Inthegroup of patients, UGT1A1*28mutantsite (TA6/7andTA7/7)canincrease theincidence ofdiarrheathanthree(5.5%vs37.5%, p <0.05)risk; abovewithout increasingthedegreeⅢneutropenia. Delayed diarrheaassociated with age, chemotherapy,background, ECOG score, etc.no significant correlation.Conclusion:Irinotecanin combination with5-fluorouracil andleucovorinin the treatmentofadvanced colorectal cancerhas a good effect, side effectscan be controlled,UGT1A1*28mutantlociaffecting FOLFIRI chemotherapy in the treatmentofadvanced colorectal cancertoxicityand efficacy.