Objective Analysis of irinotecan combined with thunder for the clinical effcacy and toxicity of pemetrexed in second-line treatment of advanced gastric cancer.Methods Selected 44 patients receiving second-line therapy of advanced gastric cancer patients as the object, given an intravenous infusion of irinotecan and raltitrexed chemotherapy, evaluate the curative effect and adverse reactions during chemotherapy and to observe the incidence and severity.Results 44 cases of patients with IV degree of diarrhea due to termination of second cycles of chemotherapy, could’t evaluate the short-term efficacy. The other 42 patients completed at least 2 cycles of chemotherapy intervention, can be used for short-term effcacy evaluation: CR in 1 cases, PR in 7 cases, SD in 18 cases, PD in 16 cases, the total clinical response rate was 19.05%, the disease control rate was 61.90%. The main side effects included white blood cells, neutrophils, thrombocytopenia, nausea and vomiting, anorexia, bone marrow suppression and liver or renal function damage, and the severity of the disease was mainly from 1 to 2. The median progression free survival was 9.2 months (range 95%CI2.7 to 4.1 months) in all of the 42 patients (95%CI 4.6 to 13.8 months).Conclusion Short and long term effect of irinotecan combined with chemotherapy as second-line treatment of advanced gastric cancer is considerable, mild side effects, safe and reliable.%目的：分析伊立替康联合雷替曲塞二线治疗晚期胃癌的临床疗效及毒副反应。方法选取44例接受二线治疗的晚期胃癌患者为对象，给予静脉滴注伊立替康和雷替曲塞方案化疗，评估近期疗效，并观察化疗期间毒副反应发生情况及严重程度。结果44例患者中有2例因IV度腹泻终止第2周期化疗，无法评估近期疗效。其他42例患者均至少完成2个周期的化疗干预，均可进行近期疗效评价：CR 1例， PR 7例，SD 18例，PD 16例，临床总缓解率为19.05%，疾病控制率为61.90%。主要毒副反应包括白细胞、中性粒细胞、血小板减少、恶心呕吐、厌食无力、骨髓抑制及肝或肾功能损害，且严重程度多以1～2级为主。42例患者中位无进展生存时间3.4个月（95%CI：2.7～4.1个月），中位生存时间9.2个月（95%CI：4.6～13.8个月）。结论伊立替康联合化疗二线治疗晚期胃癌临床近远期疗效可观，毒副反应轻，安全可靠。
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