卡培他滨联合奥沙利铂治疗晚期大肠癌的临床观察

目的观察卡培他滨联合奥沙利铂组成的XELOX方案治疗晚期大肠癌的近期疗效与安全性。方法采用XELOX方案治疗晚期大肠癌62例。卡培他滨2000mg/m^2,d1～14,分早晚口服;奥沙利铂130mg/m^2,d1,静点。每21天为1周期,至少2周期。结果近期疗效CR1例,PR26例,SD20例,PD15例,有效率43.5%。初治组有效率55.6%,显著高于复治组的26.9%（P〈0.05）。毒副反应主要为可耐受的骨髓抑制、恶心呕吐、外周神经毒性。结论XELOX方案治疗晚期大肠癌疗效较好,毒副反应轻,是晚期大肠癌,特别是初治者的有效治疗方案。     

卡培他滨联合奥沙利铂一线治疗老年晚期大肠癌58例

[目的]评价卡培他滨联合奥沙利铂(XELOX方案)一线治疗老年晚期大肠癌的疗效和毒副反应。[方法]58例老年(≥65岁)晚期大肠癌患者,奥沙利铂130mg/m2,第1d静脉滴注;卡培他滨2000mg/(m2·d),每天2次口服,第1～14d,21d为1个周期。[结果]58例患者中CR3例,PR25例,SD14例,PD16例,有效率为48.28%。中位生存期为15.8个月,中位疾病进展时间为8.1个月。毒副反应主要为手足综合征、神经毒性、骨髓抑制、恶心、呕吐多为Ⅰ～Ⅱ度。[结论]卡培他滨联合奥沙利铂的方案疗效确切,毒副反应小,老年患者能耐受,能提高生活质量。     

周剂量奈达铂联合卡培他滨治疗晚期食管癌

目的：观察周剂量奈达铂联合卡培他滨治疗晚期食管肿瘤的疗效和毒性。方法：奈达铂40mg／m^2，静脉滴入第1、8d；卡培他滨1250mg／（m^2·d），分2次口服，第1～14d。结果：治疗组38例患者中，获CR2例，PR14例，总有效率（CR＋PR）42．1％；对照组30例患者中CR1例，PR7例，总有效率26．6％。主要毒副反应以骨髓抑制为主，表现为白细胞和血小板减少、恶心呕吐、感觉性神经毒性、口腔粘膜炎、腹泻、手足综合症等。结论：周剂量奈达铂联合卡培他滨方案治疗晚期食管癌疗效显著，且毒副作用小，值得临床进一步研究。     

卡培他滨联合奥沙利铂治疗进展期胃癌68例

目的：观察卡培他滨联合奥沙利铂治疗进展期胃癌的疗效及安全性。方法：经病理证实的进展期胃癌患者，应用卡培他滨2000mg／m^2，分早晚2次口服，d1-d14，服用2周后休息1周；奥沙利铂130mg／m^2，静脉滴注，持续4h以上，d1，21天为1个周期。结果：全组68例患者，获CR2例，PR34例，总有效率为52．9％，中位疾病进展时间（TTP）为7．3个月。中位生存期（OS）11．9个月。1年生存率为42．9％。毒副反应以Ⅰ～Ⅱ度为主，出现Ⅲ度白细胞减少3例、血小板减少5例、恶心呕吐1例以及腹泻4例，无Ⅳ度毒副反应。结论：卡培他滨联合奥沙利铂治疗进展期胃癌有效率较高，毒副反应较低，患者耐受性好。     

卡培他滨联合多西紫杉醇和奥沙利铂治疗晚期转移性食管癌的临床观察

目的 观察卡培他滨联合多西紫杉醇和奥沙利铂治疗晚期转移性食管癌的l临床疗效和毒副反应.方法 50例晚期转移性食管癌接受卡培他滨联合多西紫杉醇和奥沙利铂的联合方案化疗.应用卡培他滨(1 000 mg/m2,d1～14)+多两紫杉醇(30 mg/m2,d.)+奥沙利铂(50 mg/m2,d1),21 d为1周期,治疗后2个周期评价疗效和毒副反应.结果 全组50例中,无CR,PR 19例,SD 20例,PD 11例,总有效率为38%.中位肿瘤进展时间3.4个月.主要毒副反应为中性粒细胞减少(38%)、手足综合征(36%)、腹泻(44%),恶心呕吐(56%)、周围神经毒性(62%).结论 卡培他滨联合多西紫杉醇和奥沙利铂方案治疗晚期转移性食管癌疗效确切、毒副反应可耐受.     

卡培他滨联合奥沙利铂治疗老年晚期大肠癌疗效观察

目的：评价卡培他滨联合奥沙利铂方案治疗晚期结直肠癌的疗效与毒副反应。方法：奥沙利铂130mg／m^2静滴，持续3h-4h，第1天；希罗达2000mg／m^2，口服早晚各1次，连服14d。3—4周为1个周期，连用3个周期后评价疗效。结果：38例患者中CR2例、PR16例、SD15例、PD5例，RR47．4％，TTP10．2个月，MST17、3个月。主要毒副作用有消化道反应、周围神经毒性、手足综合征、血液学毒性。上述反应症状较轻，多为Ⅰ-Ⅱ度，均可耐受。结论：卡培他滨联合奥沙利铂方案疗效好，副作用少，用药简单、方便，适用于年老体弱患者。     

卡培他滨联合奥沙利铂时辰治疗晚期胃肠癌的临床观察

目的：观察卡培他滨（Xeloda）联合奥沙利铂（L-OHP）（Xelox方案）时辰治疗晚期胃肠癌的近期疗效。方法：口服卡培他滨1000mg/m^2,2次/d,d1-14;奥沙利铂130mg/m^2＋5%葡萄糖500ml,d1,在14：00至17：00给药,持续3小时静脉滴注,采用时辰给药方法。按照WHO的标准进行评价。结果：全组21例胃肠癌患者均可进行评价,完全缓解（CR）1例,部分缓解（PR）8例,总有效率（CR＋PR）42.9%,胃癌有效率为40%,结肠、直肠癌有效率为45.5%。临床获益率（CR＋PR＋SD）66.7%。本组9例缓解（CR＋PR）,随访时间至2009年8月,中位缓解时间8个月,中位生存时间11个月。Xelox方案不良反应较轻,主要为末梢神经炎16例（76.2%）和血小板减少10例（47.6%）,患者均能耐受。结论：卡培他滨联合奥沙利铂（Xelox方案）时辰治疗晚期胃肠癌,安全有效,不良反应较轻,是治疗晚期胃肠癌较好的方案。     

多西他赛联合卡培他滨和奥沙利铂治疗晚期胃癌45例

[目的]探讨多西他赛联合XELOX（卡培他滨和奥沙利铂）方案治疗晚期胃癌的疗效和毒副反应。[方法]45例晚期胃癌患者接受多西他赛75mg/m^2,d1,卡培他滨每天2000mg/m^2,分2次口服,d1-14,奥沙利铂135mg/m^2,d1,21d为1个周期．至少化疗2个周期评价疗效。[结果]总有效率为57．8％,中位疾病进展时间（TTP）为6．4个月,中位生存期10．1个月。常见毒副反应为白细胞减少、手足综合征和周围神经毒性反应等。[结论]多西他赛联合XELOX方案治疗晚期胃癌疗效明显．患者耐受性较好。     

长春瑞滨联合铂类治疗中晚期子宫内膜癌

目的：比较长春瑞滨和紫杉醇分别与铂类联合治疗中晚期子宫内膜癌的近期疗效及毒副反应。方法：33例晚期子宫内膜癌，治疗组（NP方案组）21例，长春瑞滨＋顺铂或卡铂化疗，长春瑞滨25mg／m^2，静注d1、8；顺铂25mg／m^2，静注d1～3，或卡铂（300mg／m^2或者AUC4～5）静脉滴注d1。对照组（TP方案组）12例：紫杉醇135～150mg／m^2，静注d1；顺铂或卡铂用法同前。结果：全组均完成2周期以上化疗，其中CR4例．PR14例，NC10例，PD5例。有效率（CR＋PR）54．54％。NP方案组，CR2例，PR9例，有效率（CR＋PR）52．38％；TP方案组，CR2例，PR5例，有效率（CR＋PR）58．33％，两组间无统计学差异（P〉0．05）。副反应主要为骨髓抑制、白细胞、血小板减少，Ⅲ～Ⅳ度发生率，NP组为71．43％，TP组为75．0％（P〉0．05）。结论：长春瑞滨＋铂类联合与紫杉醇＋铂类联合化疗治疗中晚期子宫内膜癌有相同的疗效且毒副反应可以耐受。     

卡培他滨联合奥沙利铂动脉灌注治疗老年胃癌肝转移

目的：观察卡培他滨联合奥沙利铂动脉灌注治疗老年胃癌肝转移的疗效,生存质量及不良反应。方法：收集38例〉65岁确诊胃癌肝转移患者,通过介入治疗在肝动脉或（和）胃左动脉灌注奥沙利铂130mg/m^2,同时口服卡培他滨每天2500mg/m^2,分早晚2次,餐后30min口服,d1-5,d8-12,d15-19,28天为一周期,两周期评价。结果：38例患者中,完全缓解（CR）4例,部分缓解（PR）16例,稳定（SD）14例,进展（PD）5例,RR率为52.6%。不良反应主要为手足综合征,消化道反应,贫血和外周神经毒性,大部分为1级,耐受良好。结论：卡培他滨联合奥沙利铂动脉灌注治疗老年胃癌肝转移安全有效,不良反应小,值得临床上进一步观察。     

伊立替康、顺铂、卡培他滨联合化疗治疗晚期食管癌的疗效观察

目的 观察伊立替康、顺铂、卡培他滨联合化疗对晚期食管癌的近期疗效及不良反应.方法 经临床明确诊断的晚期食管癌病人21例,接受伊立替康、顺铂、卡培他滨联合化疗,伊立替康180mg/m2,d1,顺铂20mg/m2,d1- d5,卡培他滨2000mg/(m2*d),分早、晚2次口服,d1- d14,3周为一周期,治疗两个周期评价疗效一次.结果 21例患者可评价客观疗效和不良反应.完全缓解(CR)1例,部分缓解(PR)9例,稳定(SD)4例,进展(PD)7例.客观效率(RR)47.6%,疾病控制率(DCR)66.7%,中位疾病进展时间(mTTP)5.8个月.主要不良反应为腹泻、中性粒细胞减少及恶心和呕吐.结论 伊立替康、顺铂、卡培他滨联合化疗对晚期食管癌的疗效较好,不良反应可以控制.     

伊立替康、顺铂、卡培他滨联合化疗治疗晚期食管癌的疗效观察

目的：观察伊立替康、顺铂、卡培他滨联合化疗对晚期食管癌的近期疗效及不良反应。方法：经临床明确诊断的晚期食管癌病人21例,接受伊立替康、顺铂、卡培他滨联合化疗,伊立替康180mg/m2,d1,顺铂20mg/m2,d1-d5,卡培他滨2000mg/（m2.d）,分早、晚2次口服,d1-d14,3周为一周期,治疗两个周期评价疗效一次。结果：21例患者可评价客观疗效和不良反应。完全缓解（CR）1例,部分缓解（PR）9例,稳定（SD）4例,进展（PD）7例。客观效率（RR）47.6%,疾病控制率（DCR）66.7%,中位疾病进展时间（mTTP）5.8个月。主要不良反应为腹泻、中性粒细胞减少及恶心和呕吐。结论：伊立替康、顺铂、卡培他滨联合化疗对晚期食管癌的疗效较好,不良反应可以控制。     

Treatment of advanced colorectal carcinoma with oxaliplatin and capecitabine: a phase II trial

BACKGROUND: The current study was designed to evaluate the antitumor activity and toxicity of capecitabine and oxaliplatin in previously untreated patients with advanced colorectal carcinoma. The primary endpoint of the study was to determine the objective response rate, and a secondary endpoint was to measure the time to disease progression. METHODS: A 2-stage trial was planned with an accrual goal of 35 patients. The treatment included oxaliplatin given at a dose of 130 mg/m2 on Day 1 of each 3-week cycle. Initially, capecitabine at a dose of 2000 mg/m2/day in 2 divided doses was given on Days 1-14 of each cycle, but this was reduced to a dose of 1500 mg/m2/day because of toxicity. Patients were followed by computed tomography scans every two cycles to evaluate treatment response, and toxicity was monitored. RESULTS: The first 13 patients on the trial received the higher dose of capecitabine. Although 5 responses (38.5%) were noted, 5 patients were hospitalized with diarrhea and dehydration. This toxicity led to a decrease in the dose of capecitabine to 1500 mg/m2/day and an additional 35 patients were treated. At the lower dose, the partial response rate was 37.1% (95% confidence interval [95% CI], 21.5-55.1%). The estimated median progression-free survival was 6.9 months (95% CI, 4.4-8.2 months). At the lower dose, four patients were hospitalized with diarrhea/dehydration (with one death reported), one with febrile neutropenia, and one with ventricular fibrillation. Overall, Grade (according to version 2.0 of the National Cancer Institute Common Toxicity Criteria) 3-4 diarrhea was reported to develop in 20% of those patients treated at the capecitabine dose of 1500 mg/m2/day compared with 62% of patients treated at the dose of 2000 mg/m2/day. CONCLUSIONS: The combination of oxaliplatin and capecitabine is an active and convenient regimen for the treatment of patients with advanced colorectal carcinoma and should be compared with other front-line regimens as therapy for disease.     

Randomized multicenter Phase II trial of two different schedules of irinotecan combined with capecitabine as first-line treatment in metastatic colorectal carcinoma

BACKGROUND: The aim of the current randomized Phase II study was to investigate the efficacy and safety of capecitabine combined with irinotecan as first-line treatment in metastatic colorectal carcinoma (CRC). METHODS: A total of 140 patients received capecitabine at a dose of 1250 mg/m(2) twice daily on Days 2-15 and irinotecan at a dose of either 300 mg/m(2) on Day 1 (Arm A) or 150 mg/m(2) on Days 1 and 8 (Arm B) every 3 weeks. During the course of the study, enrollment was continued using lower doses of capecitabine (1000 mg/m(2) twice daily) and irinotecan (Arm A: 240 mg/m(2); Arm B: 120 mg/m(2)) to improve the safety profile of the combinations. RESULTS: Efficacy was evaluable in 134 patients (68 in Arm A, 66 in Arm B). Objective responses were observed in 46% of the patients (8% complete response [CR]), including 47% in Arm A (9% CR; 38% partial response [PR]) and 44% in Arm B (8% CR; 36% PR). The median progression-free survival was 8.3 months in Arm A and 7.6 months in Arm B. Among the first 52 patients treated with the higher doses, the most frequent Grade 3-4 adverse event was diarrhea (27%). The lower doses adopted in the subsequent 88 patients led to better diarrhea control, particularly in Arm A, and significant reductions in the incidence of all-grade hand-foot syndrome and abdominal pain. CONCLUSIONS: The capecitabine and irinotecan combination was a highly active first-line therapy in metastatic CRC. An acceptable safety profile was observed after dose reduction, particularly when irinotecan was administered on 1 day.     

Capecitabine as first-line treatment for patients older than 70 years with metastatic colorectal cancer: an oncopaz cooperative group study.

PURPOSE: To determine the tolerability of capecitabine in elderly patients with advanced colorectal cancer (CRC). PATIENTS AND METHODS: Fifty-one patients with advanced CRC who were >/= 70 years and considered ineligible for combination chemotherapy received oral capecitabine 1,250 mg/m(2) twice daily on days 1 to 14 every 3 weeks. Patients with a creatinine clearance of 30 to 50 mL/min received a dose of 950 mg/m(2) twice daily. RESULTS: A total of 248 cycles of capecitabine were administered (median, five cycles; range, one to eight cycles). The overall response rate was 24% (95% CI, 15% to 41%), including two complete responses (CR; 4%) and 10 partial responses (PR; 20%). Disease control (CR + PR + stable disease) was achieved in 67% of patients. The median times to disease progression and overall survival were 7 months (95% CI, 6.4 to 9.5 months) and 11 months (95% CI, 8.6 to 13.3 months), respectively. Of the 35 patients evaluated for clinical benefit response, 14 (40%; 95% CI, 24% to 58%) showed clinical benefit. Capecitabine was well tolerated. Treatment-related grade 3 and 4 adverse events were observed in only six patients (12%), and the most common events were diarrhea, hand-foot syndrome, and thrombocytopenia. One patient (2%) had an episode of angina, but no treatment-related deaths were reported. CONCLUSION: Our findings suggest that capecitabine is effective and well tolerated in elderly patients with advanced CRC who are considered ineligible for combination chemotherapy.     

希罗达联合奥沙利铂治疗晚期胃癌的临床疗效观察

目的：观察希罗达（Xeloda）联合奥沙利铂（L—OHP）治疗晚期胃癌的疗效和毒副作用。方法：L—OHP130mg／m2，加入5％GS500rrd中静脉滴注2小时，第一天，Xeloda1000mg／m2，2次／d口服，第1—14天，21天为一周期，连用2个周期后评价疗效。结果：23例患者中，CR1例PR11例SD8例PD3例，RR52．2％，中位疾病进展时间（TTP））5．8个月（3—8个月），中位生存期（MST）11个月（6—17个月），1年生存率34．8％。毒副反应主要为骨髓抑制、消化道反应、神经毒性和手足综合征，大多能耐受。结论：希罗达联合奥沙利铂治疗晚期胃癌具有较好的疗效，毒副作用小，能显著提高患者的生活质量，值得临床推广。     

Mitomycin-C, adriamycin, 5-fluorouracil and leucovorin (L-FAM2) in the treatment of advanced gastric cancer: a phase II study

Thirty previously untreated patients with advanced measurable gastric cancer were given a combination chemotherapy consisting of 5-fluorouracil, 400 mg/m2, and leucovorin, 200 mg/m2 iv on days 1 to 3, mitomycin-C, 10 mg/m2 on day 1 (every other cycle) and adriamycin, 40 mg/m2 on day 2, repeated every 21 days. The overall response rate was 46% (14/30; 95% confidence limits: 28%-64%) including 4 patients with a complete remission. Eight patients progressed. Median duration of remission (CR+PR) was 10 months, with a median survival of 13, 8 and 4 months for CR+PR, NC and PD, respectively. Main toxicities were leukopenia (WHO grade III-IV in 36% of the patients) and alopecia. One patient died from myocardial infarction after an adriamycin cumulative dose of 480 mg/m2. No other treatment-related death occurred. L-FAM2 is an effective combination for advanced gastric carcinoma. Further studies based on the association of leucovorin and 5-fluorouracil in combination with other active drugs are warranted.     

A phase I/II and pharmacokinetic study of irinotecan in combination with capecitabine as first-line therapy for advanced colorectal cancer.

PURPOSE: The aim of this study was to determine in patients with previously untreated advanced colorectal cancer the maximum tolerated dose (MTD) and safety profile of irinotecan in combination with capecitabine, to identify a recommended dose and to determine the response rate and time to disease progression. In addition, we aimed to explore the pharmacokinetic parameters of irinotecan and capecitabine when used in different sequences of administration, with irinotecan infusion either prior to or after the first intake of capecitabine. PATIENTS AND METHODS: One hundred patients were included: 43 patients were recruited into an extended phase I trial of alternating escalation in dose of both drugs where irinotecan was administered intravenously (i.v) on day 1 after first intake of capecitabine taken from days 1-14 twice daily, with cycles repeated every 3 weeks. After the determination of recommended dose a further 57 patients were treated in a phase II evaluation with the reverse sequence of drugs on day 1. Pharmacokinetic analysis was performed in patients treated at the recommended dose in two cohorts of patients in which the sequence of the first administration of each drug was reversed. RESULTS: The MTD of the combination was determined as irinotecan 300 mg/m2, with capecitabine 2000 mg/m2/day. Dose limiting toxicities were neutropenia and diarrhoea. The recommended dose is irinotecan intravenous (i.v.) 250 mg/m2 day 1 and capecitabine 2000 mg/m2/day days 1-14, every 3 weeks. Treatment was well tolerated, with diarrhoea the most common serious toxicity. Response rate in the phase II cohort was 42% [95% confidence interval (CI) 29% to 56%]. Median duration of response was 7.7 months (95% CI 7.5-8.9). Median time to progression was 8.3 months (95% CI 5.8-10). No significant effect on irinotecan pharmacokinetics was observed whatever the intake of capecitabine before or after irinotecan infusion. An effect of irinotecan on capecitabine and some capecitabine metabolites was observed, but irinotecan did not effect 5-fluorouracil (5-FU) pharmacokinetics. CONCLUSIONS: Irinotecan in combination with capecitabine is a well tolerated regimen with an activity comparable to, but more convenient than, irinotecan-5-FU i.v. combinations in patients with previously untreated advanced colorectal cancer. The pharmacokinetic data suggest that the sequence of administration does not impact significantly on the metabolism of the two drugs.     

Phase II study of capecitabine and oxaliplatin in first- and second-line treatment of advanced or metastatic colorectal cancer.

PURPOSE: To determine the efficacy and tolerability of combining oxaliplatin with capecitabine in the treatment of advanced nonpretreated and pretreated colorectal cancer. PATIENTS AND METHODS: Forty-three nonpretreated patients and 26 patients who had experienced one fluoropyrimidine-containing regimen for advanced colorectal cancer were treated with oxaliplatin 130 mg/m(2) on day 1 and capecitabine 1,250 mg/m(2) bid on days 1 to 14 every 3 weeks. Patients with good performance status (World Health Organization grade 0 to 1) were accrued onto two nonrandomized parallel arms of a phase II study. RESULTS: The objective response rate was 49% (95% confidence interval [CI], 33% to 65%) for nonpretreated and 15% (95% CI, 4% to 35%) for pretreated patients. The main toxicity of this combination was diarrhea, which occurred at grade 3 or 4 in 35% of the nonpretreated and 50% of the pretreated patients. Grade 3 or 4 sensory neuropathy, including laryngopharyngeal dysesthesia, occurred in 16% of patients on both cohorts. Capecitabine dose reductions were necessary in 26% of the nonpretreated and 45% of the pretreated patients in the second treatment cycle. The median overall survival was 17.1 months and 11.5 months, respectively. CONCLUSION: Combining capecitabine and oxaliplatin yields promising activity in advanced colorectal cancer. The main toxicity is diarrhea, which is manageable with appropriate dose reductions. On the basis of our toxicity experience, we recommend use of capecitabine in combination with oxaliplatin 130 mg/m(2) at an initial dose of 1,250 mg/m(2) bid in nonpretreated patients and at a dose of 1,000 mg/m(2) bid in pretreated patients.