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1.
目的 探讨卡培他滨单药或联合方案治疗晚期乳腺癌的疗效和安全性.方法 376例晚期乳腺癌患者接受如下方案治疗:(1)卡培他滨+多西紫杉醇方案:卡培他滨1000 mg/m2,口服,2次/d,第1~ 14天;多西紫杉醇60 ~75 mg/m2,静脉滴注,第1天;21 d为1个周期.(2)卡培他滨+长春瑞滨方案:卡培他滨1000 mg/m2,口服,2次/d,第1~14天;长春瑞滨25 mg/m2,静脉滴注,第1、8天;21 d为1个周期.中位治疗3个周期.(3)卡培他滨单药方案:卡培他滨1000 mg/m2,口服,2次/d,第1 ~ 14天,21 d为1个周期.结果卡培他滨单药组患者的有效率(ORR)为12.8%,临床获益率( CBR)为21.6%.一线治疗患者的ORR( 14.8%)与二线或二线以上治疗患者的ORR (12.2%)差异无统计学意义(P>0.05),但一线治疗患者的CBR( 35.2%)高于二线或二线以上治疗者(17.1%),差异有统计学意义(P<0.01).卡培他滨联合多西紫杉醇组患者的ORR为53.8%,其中一线治疗患者的ORR(48.5%)与二线或二线以上治疗患者的ORR(57.4%)比较,差异无统计学意义(P>0.05).卡培他滨联合长春瑞滨组患者的ORR为36.4%,其中一线治疗患者的ORR (60.0%)明显高于二线或二线以上治疗患者(16.7%),差异有统计学意义(P<0.01).结论 卡培他滨单药或者含卡培他滨联合方案不仅可以用于晚期乳腺癌一线治疗,也是二线或二线以上治疗的有效选择方案,患者不良反应可耐受.联合化疗有效后序贯至单药可以进一步延长乳腺癌患者的治疗时间.  相似文献   

2.
目的观察含卡培他滨方案对蒽环类和(或)紫杉类药物治疗后复发转移性乳腺癌的疗效和不良反应。方法 70例蒽环类和(或)紫杉类药物治疗后复发转移性乳腺癌患者分为两组,卡培他滨联合长春瑞滨(NX组,36例),卡培他滨800~1000mg/m2,分早晚两次服用,第1~14天,长春瑞滨25mg/m2,第1天和第8天,静脉滴注,3周为1个周期。卡培他滨联合吉西他滨(GX组,34例),卡培他滨800~1000mg/m2,分早晚两次服用,第1~14天,吉西他滨1g/m2,静脉滴注,第1天和第8天,3周为1个周期。每两个周期评价疗效,均至少治疗2个周期以上。结果 NX组患者中,完全缓1例(2.8%),部分缓解20例(55.6%),疾病稳定11例(30.6%),疾病进展4例(11.1%),有效率为58.3%,中位疾病进展时间13.5个月;完全缓解1例(2.9%),部分缓解19例(55.9%),疾病稳定12例(35.3%),疾病进展2例(5.9%),有效率为58.8%,中位疾病进展时间13.8月。常见的不良反应主要为骨髓抑制、胃肠道反应、手足综合征等。结论含卡培他滨方案治疗蒽环类和(或)紫杉类药物治疗后复发转移乳腺癌疗效确切,毒性可耐受,是治疗复发转移性乳腺癌的较好方案。  相似文献   

3.
目的:观察含长春瑞滨方案对蒽环类/紫杉类药物治疗后复发转移性乳腺癌的有效性和安全性.方法:蒽环类,紫杉类药物治疗后复发转移性乳腺癌患者61例,其中58例可评价疗效;长春瑞滨联合顺铂(NP)41例,长春瑞滨25mg/m2,第1天和第8天.静脉滴注;顺铂75~80mg/m2,静脉滴注,分割为2~5天,3周为一周期;长春瑞滨联合卡培他滨或替加氟(NF)17例,长春瑞滨用法同NP组,卡培他滨800~1 000mg/m2,分早晚两次服用,第1~14天,或替加氟600mg/m2,第2~6天,3周为一周期.化疗过程中注意观察不良反应,根据不良反应的程度调整药物用量.每两周期评价疗效.结果:长春瑞滨联合顺铂(NP)组,CR 2例(4.9%),PR 23例(56.1%),SD 14例(34.1%),PD2例(4.9%),有效率为61.0%;长春瑞滨联合卡培他滨或替加氟(NF)组,CR 1例(5.9%),PR 8例(47.1%),SD 7例(41.2%).PD 1例(5.9%),有效率52.9%.常见的不良反应主要为骨髓抑制、胃肠道反应、手足综合症、神经毒性等.结论:含长春瑞滨方案治疗蒽环类,紫杉类药物治疗后复发转移乳腺癌疗效确切,毒性可耐受,是治疗复发转移性乳腺癌的较好方案.  相似文献   

4.
目的 观察卡培他滨联合顺铂治疗晚期胃癌的近期疗效和毒副反应.方法 初治和复治的晚期胃癌28例,卡培他滨2 000 mg/m2口服d1~14;顺铂75 mg/m2静脉滴注d1,21 d为1个周期,连用2周后评价疗效.结果 总有效率53.6%(15/28).主要毒副反应为胃肠道反应、手足综合征、Ⅲ~Ⅳ度的白细胞减少各占7.2%(2/28).结论 治疗晚期胃癌,卡培他滨联合顺铂21 d方案是有效、经济和安全的.  相似文献   

5.
目的观察多西他赛联合奥沙利铂/卡培他滨治疗晚期胃癌的近期疗效和不良反应。方法47例晚期胃癌患者采用多西他赛60 mg/m~2,静脉滴注,第1天;奥沙利铂85 mg/m~2,静脉滴注,第2天;卡培他滨2000 mg/m~2,bid,口服,服10 d停4 d,14 d为1周期。3周期后评价疗效和不良反应。结果全组47例患者均可评价疗效,其中CR 4例(8.5%),PR 24例(51.1%),SD 12例(25.5%),PD 7例(14.9%),总有效率59.6%,Ⅲ/Ⅳ度中性粒细胞减少发生率51.1%。中位TTP为6.2个月(3.4~11.6个月),中位OS为11.3个月(5.9~14.6个月)。结论多西他赛联合奥沙利铂/卡培他滨治疗晚期胃癌有效率较高,血液学毒性低,近期疗效较好,用药方便、安全,明显提高了患者的生活质量。  相似文献   

6.
目的 观察经紫杉类和蒽环类治疗失败的转移性乳腺癌患者分别采用吉西他滨联合卡培他滨或氟尿嘧啶(5-FU)、吉西他滨联合顺铂或卡铂和吉西他滨联合羟基喜树碱(HCPT)进行解救治疗的疗效与安全性,探讨转移性乳腺癌经紫杉类和蒽环类治疗进展后适合的化疗方案。方法 2006年12月至2012年12月间经紫杉类和蒽环类治疗后进展的65例转移性乳腺癌患者分为:GX方案组(n=34):吉西他滨800~1000mg/m2,d1、d8;卡培他滨850~1000mg/m2 bid,d1~d14或5-FU 500mg/m2 d1~d5。GP方案组(n=21):吉西他滨800~1000mg/m2,d1、d8;顺铂70mg/m2或卡铂AUC=4~6。GH方案组(n=10):吉西他滨800~1000mg/m2,d1、d8;HCPT 6~8mg/d,持续用5~6天。21天为1周期,每两个周期评价疗效,获疾病控制的患者继续化疗至6个周期。结果 64例可评价疗效,65例可评价不良反应。GX方案组、GP方案组及GH方案组的有效率分别为36.4%、33.3%和30.0%,组间差异无统计学意义;中位无进展生存时间分别为8个月(1~22个月)、8个月(1~48个月)和6个月(2~12个月),组间差异无统计学意义(P=0.415);中位总生存时间分别为14.5个月(6~37个月)、14个月(4~48个月)和16个月(5~63个月),组间差异无统计学意义(P=0.653)。3组的3~4级不良反应的发生率均较低。结论 以吉西他滨为主的方案对既往经紫杉类和蒽环类治疗后进展的转移性乳腺癌患者有一定疗效,不良反应可耐受,为有效的解救方案。  相似文献   

7.
目的:观察比较TOX方案(多西紫杉醇联合卡培他滨、奥沙利铂)和FOLFOX4方案(氟尿嘧啶/四氢叶酸联合奥沙利铂)治疗晚期胃癌的临床疗效和不良反应,方法:50例晚期胃癌患者随机分成两组,TOX组26例,用多西紫杉醇联合奥沙利铂及卡培他滨化疗,多西紫杉醇35mg/m2,静脉滴注,第1天及第8天;奥沙利铂50mg/m2,静脉滴注,第1天及第8天;卡培他滨750mg/m2,口服,每日2次,第1天至14天;3周为1周期.FOLFOX4 组24例,用氟尿嘧啶/亚叶酸钙联合奥沙利铂方案化疗,奥沙利铂85mg/m2,静脉滴注2h,第1天;亚叶酸钙200mg/m2,静滴2h后予氟尿嘧啶400mg/m2,推注,后续600mg/m2,持续静滴22h,第1、2天;每2周重复,4周为1周期.两组均治疗2周期以上,按WHO标准评价客观疗效和不良反应.结果:入组的50例均可评价疗效,TOX组有效率61.5%,中位TTP 7.0个月,MST 12.8个月,FOLFOX4组有效率50.0%,中位TTP 5.8个月,MST 10.8个月.不良反应比较,III/IV级恶心呕吐发生率以FOLFOX4组显著(P<0.05),手足综合征以TOX组显著(P<0.05),其余不良反应发生率差异无统计学意义.结论:TOX方案与FOLFOX4方案治疗晚期胃癌疗效确切,不良反应均能耐受.两组比较以TOX方案疗效略高,III-IV级恶心呕吐发生率低,更易耐受.  相似文献   

8.
目的:观察吉西他滨联合顺铂治疗蒽环类及紫杉类耐药的转移性三阴乳腺癌的疗效、影响因素和不良反应.方法:采用吉西他滨联合顺铂治疗蒽环类及紫杉类耐药的转移性三阴乳腺癌28例.吉西他滨1000mg/m2静脉滴注, 第1、8天;顺铂80mg/m2,分3天静脉滴注, 第1-3天.化疗以21天为1个周期, 至少应用2个周期.结果: 本组患者治疗有效率为46.4%, 中位疾病进展时间为5.5个月.合并有肝脏转移者化疗效果差.无化疗相关死亡病例, 主要不良反应为骨髓抑制及胃肠道反应,Ⅲ-Ⅳ级白细胞和血小板下降分别为10.4%和7.1%.结论: 吉西他滨联合顺铂方案对蒽环类及紫杉类均耐药的转移性三阴乳腺癌仍有较好的近期疗效,不良反应可耐受,是有效的援救方案.  相似文献   

9.
为了探讨吉西他滨联合卡培他滨方案治疗蒽环类与紫杉类药物耐药的晚期转移性乳腺癌的近期疗效及不良反应,选取37例耐药的晚期乳腺癌患者,接受吉西他滨1 000 mg/m2,静脉滴入,d1、d8;卡培他滨950 mg/m2,2次/d,口服,d1~d14.每3周重复.2个周期化疗后,总有效率(CR+PR)为29.7%(11/37),疾病控制率(CR+PR+SD)为70.3%(26/37).中位进展时间为6.9个月,中位生存时间为15.5个月.最常见的毒性为骨髓抑制、手足综合征及胃肠道反应.初步研究结果提示,吉西他滨联合卡培他滨是治疗蒽环类和紫杉类耐药的晚期乳腺癌的有效方法,不良反应可以耐受.  相似文献   

10.
目的观察卡培他滨与顺铂合用治疗晚期消化道肿瘤的近期疗效.方法卡培他滨1300 mg/(m2*d),分2~3次口服,连服14 d;PDD 20 mg/次,静滴,第1~5天(或40 mg/次,静滴,第1~3天);21 d为1周期,连用2或3周期.结果可评价者35例,PR 12例,总有效率为34.3%.毒副反应主要是骨髓抑制和消化道反应.结论卡培他滨 顺铂治疗晚期消化道肿瘤可获得较高疗效,毒副反应轻,是一种较好的联合化疗方案.  相似文献   

11.
Paclitaxel and capecitabine, which have distinct mechanisms of action and toxicity profiles, have each shown high activity as single agents in gastric cancer. Synergistic interaction between these two drugs was suggested by taxane-induced upregulation of thymidine phosphorylase. We, therefore, evaluated the antitumour activity and toxicities of paclitaxel and capecitabine as first-line therapy in patients with advanced gastric cancer (AGC). Patients with histologically confirmed unresectable or metastatic AGC were treated with capecitabine 825 mg m(-2) p.o. twice daily on days 1-14 and paclitaxel 175 mg m(-2) i.v. on day 1 every 3 weeks until disease progression or unacceptable toxicities. Between June 2002 and May 2004, 45 patients, of median age 57 years (range=38-73 years), were treated with the combination of capecitabine and paclitaxel. After a median 6 cycles (range=1-9 cycles) of chemotherapy, 43 were evaluable for toxicity and response. A total of 2 patients showed complete response and 20 showed partial response making the overall response rate 48.9% (95% CI=30.3-63.5%). After a median follow-up of 42.2 months (range=31.2-54.3 months), median time to progression was 5.6 months (95% CI=3.9-7.2 months) and median overall survival was 11.3 months (95% CI=8.1-14.4 months). Grade 3 or 4 adverse events include neutropaenia (46.5% of patients), hand-foot syndrome (9.3%), arthralgia (9.3%), and asthenia (4.7%). There was no neutropaenic fever or treatment-related deaths. Paclitaxel and capecitabine combination chemotherapy was active and highly tolerable as a first-line therapy for AGC.  相似文献   

12.
目的观察比较紫杉醇联合卡培他滨方案和紫杉醇联合替加氟方案治疗晚期胃癌的临床疗效和安全性。方法 52例经病理证实的晚期胃癌患者分为A组(24例)和B组(28例)。A组:紫杉醇80~90 mg/m2,静脉滴注,第1、8天;卡培他滨1 000mg/m2,口服,2次/天,第1~14天;21 d为1个周期。B组:紫杉醇80~90 mg/m2,静脉滴注,第1、8天;亚叶酸钙200 mg/m2,静脉滴注2 h后予替加氟0.8~1.0 g,静脉滴注,第2~6天;21 d为1个周期。每例患者治疗至少2个周期。按RE-CIST标准评价客观疗效,按WHO标准评价不良反应。结果 52例患者均可评价疗效。A组24例,客观有效率(RR)为50.0%,中位进展时间(TTP)5.9个月,中位生存期(MST)12.4个月;B组28例,有效率39.3%,TTP 5.8个月,MST11.8个月。两组疗效无统计学差异(P〉0.05)。两组的主要毒副反应为骨髓抑制、胃肠道反应,多数为Ⅰ~Ⅱ度;A组手足综合征发生率为29.2%,B组未出现,差异有显著性(P〈0.01)。结论紫杉醇联合卡培他滨与紫杉醇联合替加氟治疗晚期胃癌的疗效相近,毒副反应均可耐受,但前一方案用药更方便,是治疗晚期胃癌的较好方案之一。  相似文献   

13.
目的 评价紫杉醇联合奥沙利铂和卡培他滨(POX方案)治疗晚期胃癌的疗效和不良反应。方法 21例晚期胃癌患者均采用POX方案治疗:紫杉醇85mg/m,第1、8天,静脉滴注;奥沙利铂130mg/m2,第1天,静脉滴注;卡培他滨1000mg/m分2次口服,第1~14天,21天为1周期。2周期评价疗效。结果 全组21例均可评价疗效,其中PR13例,SD6例,PD2例,客观有效率为61.9%;中位肿瘤进展时间为5.7个月,中位总生存期为11个月。不良反应主要为骨髓抑制、恶心呕吐和外周神经毒性。结论 紫杉醇联合奥沙利铂和卡培他滨治疗晚期胃癌疗效较好,不良反应可耐受,值得临床进一步研究。  相似文献   

14.
Park SH  Bang SM  Cho EK  Baek JH  Oh JH  Im SA  Park YS  Shin DB  Lee JH 《Oncology》2004,66(5):353-357
OBJECTIVE: The aim of this study was to evaluate efficacy and safety of the combination chemotherapy with irinotecan plus capecitabine in patients with advanced colorectal adenocarcinoma. METHODS: Patients with histologically proven advanced colorectal adenocarcinoma received a first-line chemotherapy with irinotecan 240 mg/m2 on day 1 and capecitabine 2,000 mg/m2/day as an intermittent regimen of 2 weeks of treatment followed by a 1-week rest. Treatment was repeated every 3 weeks. RESULTS: Thirty-nine patients were registered, and 36 were assessable for responses. Sixteen objective responses (44%) were observed with a median response duration of 6.9 months. Stable disease was documented in 14 cases (39%). The median time to progression was 6.7 months. The median overall survival was not reached at the time of analysis, and the 1-year survival rate was 67%. Two patients died: 1 due to sepsis not complicating myelosuppression, and 1 patient, known as a hepatitis B virus carrier prior to chemotherapy, died of hepatic failure, the cause of which was not clinically verified. Frequently encountered therapy-related events were leukopenia and gastrointestinal side effects including diarrhea. Severe hand-and-foot syndrome was observed in only 1 patient. CONCLUSIONS: The combination chemotherapy of irinotecan and capecitabine is an active and tolerable regimen for advanced colorectal adenocarcinoma, but the observed deaths suggest a future randomized trial that requires a cautious patient selection.  相似文献   

15.
目的 评价卡培他滨联合顺铂一线治疗晚期胃癌的有效性和安全性.方法 对符合入组标准的141例晚期胃癌患者进行卡培他滨联合顺铂方案化疗,卡培他滨1000 mg/m2,2次/d,早、晚饭后30 min内口服,第1~14 d;顺铂20 mg/m2静脉滴注,第1~5天.21 d为1个疗程,共完成了705个周期的化疗.根据实体瘤反应评估标准(RECIST)评价疗效,根据美国国立癌症研究所抗癌药物常见不良反应评价标准(3.0版)评估不良反应.化疗结束后第1年每3个月随访1次,以后每6个月随访1次.结果 完全缓解13例,部分缓解38例,稳定54例,进展36例,总有效率为36.2%.患者中位疾病进展时间为9.0个月,中位生存时间为12.0个月.最常见的血液学毒副反应是中性粒细胞减少,有24例患者(17.0%)出现3~4级中性粒细胞减少.最常见的非血液学毒性反应是手足综合征,有35例(24.8%)出现手足综合征.本组患者无治疗相关性死亡发生.结论 卡培他滨联合顺铂一线治疗晚期胃癌具有较好的疗效,患者对此方案具有较好的耐受性,并且比5-Fu联合顺铂方案更方便,适合患者门诊应用.  相似文献   

16.
PURPOSE: To compare the efficacy of two different schedules of epirubicin and paclitaxel, as first-line chemotherapy, in patients with advanced breast cancer (ABC). PATIENTS AND METHODS: From October 1997 until May 1999, 183 eligible patients with ABC entered the study. Chemotherapy in group A (93 patients) consisted of four cycles of epirubicin at a dose of 110 mg/m(2) followed by four cycles of paclitaxel at a dose of 225 mg/m(2) in a 3-hour infusion. All cycles were repeated every 2 weeks with granulocyte colony-stimulating factor support. The therapeutic regimen in group B (90 patients) consisted of epirubicin (80 mg/m(2)) immediately followed by paclitaxel (175 mg/m(2) in a 3-hour infusion) every 3 weeks for six cycles. RESULTS: In total, 79 patients (85%) in group A and 72 patients (80%) in group B completed treatment. The median relative dose-intensity of epirubicin was 0.96 in both groups, and that of paclitaxel was 0.96 and 0.97 in groups A and B, respectively. The complete response rate was higher in group A (21.5% v 9% P =.02). Nevertheless, there was no significant difference in the overall response rate between the two groups (55% v 42%, P =.10). Severe neutropenia was more frequently observed with concurrent treatment. After a median follow-up of 16.5 months, median time to progression was 10 months in group A and 8.5 months in group B (P =.27), and median survival was 21.5 and 20 months, respectively (P =.17). CONCLUSION: The present study failed to demonstrate a significant difference in overall response rate between dose-dense sequential administration of epirubicin and paclitaxel compared with the combination of the two drugs given on the same day, even though the sequential treatment resulted in a significantly higher complete response rate.  相似文献   

17.
目的观察紫杉醇脂质体联合5-FU/DDP治疗晚期食管癌的疗效及不良反应。方法 49例患者使用紫杉醇脂质体135 mg/m2,5-FU 500 mg/m2静脉滴注,第1-5天;顺铂25 mg/m2静脉滴注,第1-3天。21天为1周期,连用2周期后按照实体瘤疗效评价标准(RECIST 1.0)评价疗效。结果 49例患者共完成212周期化疗,平均完成4.3周期,CR 4例(8.2%),PR 19例(38.8%),SD 12例(24.4%),PD 14例(28.6%),总有效率(CR+PR)47.0%,临床受益率(CR+PR+SD)74.4%。中位疾病进展时间6月(95%CI:5.09~6.91)。49例患者1年生存率为79.6%(39/49),2年生存率为46.9%(23/49)。不良反应主要为血液学毒性及消化道反应。结论紫杉醇脂质体联合5-FU/DDP治疗晚期食管癌具有较好的有效性及安全性。  相似文献   

18.
紫杉醇联合卡培他滨一线治疗晚期胃癌的临床观察   总被引:1,自引:0,他引:1       下载免费PDF全文
目的 观察紫杉醇联合卡培他滨一线治疗晚期胃癌的疗效和毒副反应。方法 晚期胃癌患者20例,给予紫杉醇80mg/m2静脉滴注,第1、8天;卡培他滨1000mg/m2,分早晚各口服1次,第1~14天;21天为1周期。每2周期评价疗效。结果 19例可评价疗效,获CR1例,PR7例,总有效率(RR)为42.1%。中位无进展生存期和总生存期分别为4.8个月和9.7个月,1年生存率为36.8%。主要的毒副反应为血液学毒性、脱发和手足综合症。结论 紫杉醇联合卡培他滨治疗晚期胃癌安全、有效,值得临床进一步应用。  相似文献   

19.
To evaluate the efficacy and safety of capecitabine and cisplatin in patients with recurrent gastric cancer after fluoropyrimidine-based adjuvant therapy. Patients with histologically confirmed and measurable advanced gastric cancer that had relapsed after fluoropyrimidine-based adjuvant chemotherapy received oral capecitabine (1250 mg m(-2) twice daily, days 1-14) and intravenous cisplatin (60 mg m(-2) over 1 h, day 1) every 3 weeks. In total, 32 patients were enrolled, of whom 30 were evaluable for efficacy and 32 for safety. A median of 5 cycles (range 1-10) was administered. One patient achieved a complete response and eight had partial responses, giving an overall response rate of 28% (95% CI, 13-44%). The median time to progression and median overall survival were 5.8 months (95% CI, 4.1-7.5 months) and 11.2 months (95% CI, 5.5-16.9 months), respectively. Grade 3 neutropenia and thrombocytopenia were observed in 38 and 6% of patients, respectively. Grade 2/3 nonhaematological toxicities included diarrhoea (19%), stomatitis (19%) and hand-foot syndrome (31%). No grade 4 toxicity, neutropenic fever or treatment-related deaths occurred. Capecitabine in combination with cisplatin was effective and well tolerated as first-line treatment in patients with recurrent gastric cancer after fluoropyrimidine-based adjuvant chemotherapy.  相似文献   

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