紫杉醇联合顺铂及卡培他滨治疗晚期胃癌

目的探讨紫杉醇联合顺铂及卡培他滨一线治疗晚期胃癌的疗效和安全性。方法回顾性分析2004年6月-2008年6月收治的使用PCX方案化疗的32例晚期胃癌患者的临床资料。化疗方案：紫杉醇（PTX）150mg／m^2,静脉滴注2h,第1天;顺铂（DDP）25mg／m^2,静脉滴注,第1—3天;卡培他滨1250mg／m^2,口服,第1—14天。21d为1周期,用药至少2个周期后进行疗效评价。结果32例患者均可评价疗效,完全缓解1例,部分缓解12例,稳定13例,进展6例,总有效率40．6％;中位疾病进展时间（TTP）6．1个月（2～14个月）,中位生存时问（MST）11个月（2-31个月）。主要不良反应为胃肠道反应和骨髓抑制,多为Ⅰ或Ⅱ度。Ⅲ／Ⅳ度不良反应主要有恶心、呕吐（21．9％,7／32）、中性粒细胞减少（15．6％,5／32）和乏力（9．4％,3／32）。12．5％（4／32）的患者出现中性粒细胞减少性发热。所有患者均无化疗相关性死亡。结论紫杉醇联合顺铂及卡培他滨一线治疗晚期胃癌有较好的疗效,不良反应可以耐受。     

卡培他滨联合顺铂治疗晚期消化道肿瘤的观察及护理

卡培他滨（商品名：希罗达）是一种对肿瘤细胞有选择性的口服细胞毒性药物,其本身无细胞毒性,但可转化为具有细胞毒性的5-氟尿嘧啶。我科自2003年4月～2004年4月将卡培他滨联合顺铂试用于晚期食管癌和胃癌患15例,效果良好。现将其护理体会报告如下。     

周剂量紫杉醇联合顺铂、卡培他滨治疗晚期胃癌的临床研究

目的观察周剂量紫杉醇联合顺铂、卡培他滨方案治疗晚期胃癌的客观疗效、疾病进展时间和不良反应。方法77例晚期胃癌患者随机分为2组,治疗组39例晚期胃癌患者接受周剂量紫杉醇75 mg/m^2（d1、d8、d15）,顺铂25 mg/m2（d1、d8、d15）,卡培他滨每日1 250 mg/m^2,分2次口服,d1-d14,28 d为1周期,疗程2-6周期。对照组38例晚期胃癌患者接受奥沙利铂85 mg/m^2,d1,亚叶酸钙200 mg/m^2（2 h静脉输注）d1-d2,而后5-氟尿嘧啶（5-Fu）400 mg/m^2（10 min静脉推注）及5-Fu 600 mg/m^2（持续静脉泵入22 h）,d1-d2,每14天重复,2次为1周期。结果治疗组有效率显著高于对照组（59.0%vs 47.4%,P〈0.05）,TTP治疗组较对照组显著延长（6.8个月vs 5.8个月,P〈0.05）。治疗组手足综合征发生率显著高于对照组（P〈0.01）,其他不良反应按分级比较2组无显著性差异（P〉0.05）。Karnofsky评分治疗组改善率较对照组显著增高（P〈0.05）。结论周剂量紫杉醇联合顺铂、卡培他滨化疗方案治疗晚期胃癌近期疗效显著,耐受性较好。     

紫杉醇联合顺铂腹腔灌注并口服卡培他滨治疗晚期胃癌临床观察

目的:观察紫杉醇联合顺铂腹腔灌注并口服卡培他滨治疗晚期胃癌的疗效及毒副反应。方法:经组织病理学或细胞学证实的30例晚期胃癌,采用紫杉醇(PTX)150mg/m2,静脉滴注d1;顺铂(DDP)70mg/m2,腹腔灌注d1～d7;卡培他滨(CAP)2 000 mg/m2口服;每21天为1个周期。分别化疗2～4个周期后按RECIST标准评价疗效,按NCFCTC标准评价毒副反应。结果:30例均可评价疗效,完全缓解(CR)1侧,部分缓解(PR)13例,病情稳定(SD)10例,疾病进展(PD)6例,总有效率(RR)46.7%。毒副反应主要为骨髓抑制、恶心呕吐、腹泻、手足综合征、末梢神经毒性。结论:紫杉醇联合顺铂腹腔灌注并口服卡培他滨治疗晚期胃癌有较好疗效,可明显改善生活质量,延长生存时间,毒副反应轻,易于耐受。     

奥沙利铂联合卡培他滨治疗晚期胃癌毒副反应护理

[目的]探讨奥沙利铂联合卡培他滨治疗晚期胃癌毒副反应的护理对策。[方法]对35例应用奥沙利铂联合卡培他滨治疗晚期胃癌所致的毒副反应进行相应的护理。[结果]35例化疗期间毒副反应主要表现为周围神经毒性、手足综合征、消化道反应、骨髓抑制等,多数为Ⅰ度或Ⅱ度,经对症处理及护理后缓解,病人化疗耐受好。[结论]恰当有效的护理措施可以预防和减轻毒副反应的发生,确保化疗顺利进行。     

奥沙利铂联合卡培他滨治疗晚期胃癌的研究

目的 评价奥沙利铂联合卡培他滨方案治疗进展及转移胃癌的疗效与安全性。方法奥沙利铂130mg／m^2．静脉滴注2h,第1d;卡培他滨2500mg／m^2,分早晚2次口服,第1～14d,每3周重复,行2周期治疗后判定疗效。结果入组观察40例,其中行原发灶切除者14例,未切除者26例。可评价疗效者40例,其中完全有效（CR）4例（10．0％）,部分有效（PR）20例（50．0％）,稳定（SO）8例（20．0％）,进展（PD）8例（20．0％）。有效率（ORR）60．0％（24／40）,初治（一线）ORR 66．7％（20／30）,复治（二线以上）ORR 40．0％（4／10）。中位无进展期（mTTP）9．7个月,中位总生存期（mOS）13．5个月。毒副作用手足综合征、神经毒性,多为Ⅰ～Ⅱ度。结论奥沙利铂联合卡培他滨方案治疗晚期胃癌疗效高,毒副作用小,患者易耐受,生活质量提高。     

奥沙利铂联合卡培他滨治疗晚期胃癌毒副反应护理

[目的]探讨奥沙利铂联合卡培他滨治疗晚期胃癌毒副反应的护理对策。[方法]对35例应用奥沙利铂联合卡培他滨治疗晚期胃癌所致的毒副反应进行相应的护理。[结果]35例化疗期间毒副反应主要表现为周围神经毒性、手足综合征、消化道反应、骨髓抑制等,多数为Ⅰ度或Ⅱ度,经对症处理及护理后缓解,病人化疗耐受好。[结论]恰当有效的护理措施可以预防和减轻毒副反应的发生,确保化疗顺利进行。     

卡培他滨联合顺铂一线治疗晚期食管癌的临床观察

目的:观察卡培他滨联合顺铂一线治疗晚期食管癌的近期疗效和不良反应。方法:18例Ⅳ期食管癌患者,用卡培他滨1 250m g/(m2.d),每日分2次口服,第1~14 d;顺铂20 m g/次,静脉滴注,第1~5 d(或40 m g/次,静脉滴注,第1~3 d);21 d为1周期,至少应用2周期。结果:共治疗18例,其中完全缓解1例,部分缓解9例,总有效率为55.56%。主要不良反应是骨髓抑制和消化道反应。结论:卡培他滨联合顺铂一线治疗晚期食管癌可获得较高的疗效,不良反应轻,是一种较好的化疗方案。     

奥沙利铂联合卡培他滨方案治疗晚期胃癌68例临床分析

晚期胃癌患者68例随机分为治疗组和对照组,各34例。治疗组采用奥沙利铂联合卡培他滨方案进行治疗,对照组采用奥沙利铂和亚叶酸钙的治疗方案,比较两组患者的临床疗效,观察两组患者的不良反应。治疗组的治愈率为88.24%（30/34）,对照组的治愈率为61.76%（21/34）,两组具有显著性差异（P〈0.05）,具有统计学意义。治疗组发生不良反应5例,恶心呕吐3例,腹泻2例;对照组发生不良反应8例,发生恶心呕吐4例,腹泻3例,骨髓抑制1例,两组无显著性差异（P〉0.05）。奥沙利铂联合卡培他滨方案治疗晚期胃癌不失为一种优良的治疗方案,不但提高了患者的依从性和生活质量,还降低了患者的不良反应,值得在临床上推广使用。     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

目的 观察并比较多西他赛联合卡培他滨与奥沙利铂联合卡培他滨治疗老年晚期胃癌的近期疗效和不良反应.方法 82例老年晚期胃癌患者随机分为2组:多西他赛组38例,应用多西他赛(75mg/m2,静脉滴注1 h,第1天)联合卡培他滨[2000 mg/(m2·d),分2次口服,第1～14天]治疗,停服1周,第21天重复治疗;奥沙利铂组44例应用奥沙利铂(100 mg/m2,静脉滴注1 h,第1天)联合卡培他滨(剂量同上)治疗;21 d为1个周期,均化疗2个周期以上,2个周期后复查评价疗效.结果 82例均完成随访,多西他赛组有效率为52.63%(20/38),中位无进展生存期(PFS)为6.1个月.奥沙利铂组有效率为54.55%(24/44),PFS为6.3个月.2组有效率(χ2=0.030,P=0.862)和PFS(χ2=1.39,P=0.19)差异均无统计学意义.2组患者主要不良反应为胃肠反应和骨髓抑制;神经毒性也较常见,多为Ⅰ度或Ⅱ度毒性反应,Ⅲ度或Ⅳ度毒性反应少见,主要为恶心呕吐、白细胞和血小板计数降低.2组间各项不良反应发生率差异无统计学意义(P均>0.05),均无化疗相关性死亡.结论 多西他赛联合卡培他滨与奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效相当,不良反应均可耐受.     

卡培他滨联合紫杉醇或草酸铂治疗晚期胃癌近期疗效及不良反应比较

目的比较卡培他滨联合紫杉醇和卡培他滨联合草酸铂治疗晚期胃癌的近期疗效及不良反应。方法采用随机的分组方法,将36例晚期胃癌患者分为卡培他滨 紫杉醇方案组(A组:17例)与卡培他滨 草酸铂方案组(B组:19例)。结果共有32例可评价疗效,A组16例有效率62.5%(10/16),B组16例有效率37.5%(6/16),两组疗效有显著性差异(P<0.05)。两组不良反应主要为轻度的骨髓抑制、恶心呕吐、口腔黏膜炎、手足综合征、末梢神经炎以及脱发、腹泻等。结论两方案治疗晚期胃癌均取得较好的有效率,且毒副作用可以耐受,卡培他滨联合紫杉醇的近期疗效优于卡培他滨联合草酸铂。     

卡培他滨口服联合顺铂腹腔化疗治疗胃癌伴腹水的临床疗效观察

选取我院2012年1月~2013年12月收治的40例胃癌伴腹水患者,分为观察组和对照组各20例。对照组使用亚叶酸钙和5-氟尿嘧啶静脉滴注联合顺铂腹腔化疗,观察组患者使用卡培他滨口服联合顺铂腹腔化疗,比较两组的治疗疗效。结果观察组患者的疾病进展时间、临床受益反应以及不良反应发生率都优于对照组患者,差异具有统计学意义。卡培他滨口服联合顺铂腹腔化疗可以有效治疗胃癌伴腹水,值得大力推广使用。     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

奥沙利铂联合卡培他滨在老年胃癌根治术后患者中的应用观察

目的探讨奥沙利铂联合卡培他滨在老年胃癌根治术后患者中的应用效果。方法选择接受胃癌根治术治疗的96例老年胃癌患者,按随机数字表法者分为观察组和对照组各48例。两组均行常规治疗,对照组在此基础上采用奥沙利铂治疗,观察组在对照组基础上增加卡培他滨治疗,比较两组T细胞亚群水平及不良反应发生情况。结果治疗6w后,观察组CD3~+、CD4~+、CD8~+水平较对照组高,差异有统计学意义(P<0.05);观察组不良反应发生率29.17%(14/48)较对照组25.00%(12/48)无明显上升,差异无统计学意义(P>0.05)。结论奥沙利铂与卡培他滨联合治疗能有效提升老年胃癌根治术后患者T细胞亚群水平,且不良反应发生率不会增加,安全性较高。     

吉西他滨联合卡培他滨与顺铂治疗耐药性晚期乳腺癌的近期疗效及不良反应比较

目的：比较吉西他滨联合卡培他滨（ GC）方案与联合顺铂（ GP）方案治疗蒽环类和紫衫类药物耐药晚期乳腺癌的近期疗效、不良反应和生存时间。方法经过紫杉醇蒽环类药物治疗失败的50例乳腺癌患者利用随机数据表分成GC组和GP组各25例,分别给予吉西他滨联合卡培他滨及吉西他滨联合顺铂治疗,均21天为1个周期。化疗2个周期后进行疗效及不良反应评价。结果两组有效率（response rate,RR）及疾病控制率（disease control rate,DCR）差异均无统计学意义（P ＞0.05）;GC组手足综合征的发生率显著高于GP组（ P＜0.05）,其余不良反应两组差异无统计学意义（ P ＞0.05）。结论吉西他滨联合卡培他滨方案治疗晚期乳腺癌疗效及安全性与吉西他滨联合顺铂方案相当,但后者给药更方便。     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

卡培他滨联合草酸铂、紫杉醇治疗晚期胃癌25例临床观察

近年来新的化疗药物相继问世,使晚期胃癌的疗效明显提高,而且不良反应也减轻[1-3].2006年1月～2007年12月作者采用卡培他滨联合草酸铂和紫杉醇方案治疗晚期胃癌,疗效较好,报道如下.