The Clinical Analysis Of The Influence Of Irinotecan-induced Diarrhea On The Absorption Of Capecitabine And The Efficacy Of The Modified XELIRI Regimen

Background: As an oral fluoropyrimidine, capecitabine is widely used in clinic because of its convenience and safety. Studies have shown that patients with gastrointestinal tumors treated with XELIRI regimen(irinotecan plus capecitabine)achieved certain curative effect, but due to the higher risk of diarrhea and the influence of the absorption of capecitabine, the XELIRI regimen is limited in clinical applications to some degree.Objective: To research the influence of irinotecan-induced diarrhea on the absorption of capecitabine, and evaluate the efficacy and safety of the modified regimen for irinotecan combined with capecitabine.Methods: 5 patients with digestive system malignant tumors of second affiliated hospital of Dalian medical university since May 2014- February 2015 Were treated with the application of the method of delay 7 days oraling capecitabine after irinotecan, namely modified XELIRI regimen(capecitabine and irinotecan) or modified XELIRINOX regimen(capecitabine, irinotecan and oxaliplatin) for at least 2 cycles to assess the short-term curative effect and toxicity of the modified regimens by means of clinical manifestations and auxiliary examination results.Results: Total1 y 15 cycles were completed and mean cycle was 3 in 5 cases, including 3 cases in modified XELIRI regimen and 2 cases in XELIRINOX regimen. 5 cases were evaluable for toxicity, 4 cases were evaluable for short-term curative effect. There was no grade 3/4 adverse event happened, the main adverse events were grade1 diarrhea, neutropenia, nausea and vomiting, hepatic toxicity and grade 2 hemoglobin. Among 5 cases, there was 1 case of postoperative adjuvant chemotherapy, 4 cases achieved SD, with disease control rates of 100%.Conclusion:1.the application of the modified method of delay oraling capecitabine after irinotecan reduces the risk of grade 3/4 diarrhea, does not affect the absorption of capecitabine.2.The modified XELIRI and XELIRINOX regimens for digestive system malignant tumors can obtain mild adverse reactions with non-inferiority efficacy. The modified XELIRI and XELIRINOX regimens are worthy of clinical generalization and further clinical observation.