奥沙利铂联合卡培他滨治疗体力状况削弱的晚期胃癌临床观察

为了评估奥沙利铂联合卡培他滨治疗体力状况削弱的(KPS≤70)晚期胃癌的毒性和疗效,应用奥沙利铂联合卡培他滨治疗21例晚期胃癌患者。奥沙利铂100mg/m2,静脉滴入,持续3h,d1;卡培他滨1650mg/(m2·d),分2次口服,d1~d14;21d为1个周期。患者每2个周期行CT检查以评估疗效,并监控其毒性。结果:所有患者均可评估毒性,21例中有20例可评估疗效。PR6例(30%),SD8例(40%),PD6例(30%),有效率为30·0%。中位进展时间4·5个月,中位生存时间8·3个月。初步研究结果提示:奥沙利铂联合卡培他滨治疗体力状况削弱(KPS≤70)的晚期胃癌有效,且有良好的耐受性。     

奥沙利铂联合卡培他滨治疗进展期胃癌的临床观察

目的:评价奥沙利铂联合卡培他滨治疗进展期胃癌的疗效、不良反应和安全性。方法:45例进展期胃癌(AGC)患者采用奥沙利铂联合卡培他滨(XELOX)方案化疗,奥沙利铂130mg/m2,静脉滴注2h,d1;卡培他滨2000mg/m2,分2次口服,d1-14,21天为一个周期,2个周期后评价疗效。结果:45例中有43例可评价疗效,获完全缓解(CR)1例(2.33%),部分缓解(PR)25例(58.14%),无变化(SD)14例(32.56%),进展(PD)3例(6.98%)。对所有患者随访12个月,中位疾病进展时间(mTTP)5.7个月,中位生存时间(mOS)11.6个月。主要不良反应有骨髓抑制、外周神经毒性、胃肠道反应、手足综合征等,无治疗相关性死亡。结论:XELOX方案治疗AGC有一定疗效,患者耐受性良好,值得临床推广。     

多西他赛联合奥沙利铂卡培他滨治疗晚期胃癌的临床研究

目的:临床观察多西他赛联合奥沙利铂、卡培他滨治疗晚期胃癌的疗效及不良反应.方法:56例晚期胃癌患者接受多西他赛75 mg/m2,d1,奥沙利铂85 mg/m2,d2,卡培他滨每天1 000 mg/m2,bid,d1～d14,21d为1个周期,化疗2个周期后评价疗效.结果:56例患者均可评价疗效,其中CR 6例(10.7%),PR 30例(53.6%),SD 12例(21.4%),PD 8例(14.3%),总有效率64.3%,中位TTP为6.2个月(3.6～11.8个月),中位OS为11.6个月(5.9～14.6个月).常见不良反应为骨髓抑制、胃肠道反应和外周神经炎,无化疗相关性死亡.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,提高了患者的生活质量.     

卡培他滨联合奥沙利铂治疗进展期胃癌老年患者的疗效观察

目的探讨卡培他滨(xeloda)联合奥沙利铂(L-OHP)治疗进展期胃癌老年患者的客观疗效和不良反应。方法以60例进展期老年胃癌患者为研究对象,采用XELOX方案,即静脉滴注奥沙利铂85 mg/m2,d1;卡培他滨1 250mg/m2,分2次口服,d1~14;以28 d为1个化疗周期,连用3个周期后评价该治疗方案的疗效和毒性以及患者的生活质量改善状况。结果 60例患者均可评价,其中5例完全缓解,25例部分缓解,14例处于稳定期,16例患者处于进展期,总有效率为50.0%;不良反应为手足综合征、神经毒性、骨髓抑制和胃肠道反应,均为可逆性。结论奥沙利铂联合卡培他滨治疗进展期老年胃癌患者疗效肯定,安全性较好,患者耐受性高,可改善患者的生活质量。     

多西他赛联合奥沙利铂/卡培他滨治疗晚期胃癌47例临床观察

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。     

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/m2,同时口服卡培他滨每天2500mg/m2,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。     

多西他赛联合奥沙利铂、卡培他滨一线治疗晚期胃癌临床观察

目的:评价多西他赛(TXT)联合奥沙利铂(OXA)、卡培他滨(Xeloda)治疗晚期胃癌的近期疗效及不良反应.方法:19例晚期胃癌患者接受多西他赛75mg/m2,d1,奥沙利铂85mg/m2,d2,卡培他滨每天1000mg/m2,bid,d1-14,21d为1个周期,化疗2个周期后评价疗效.结果:19例患者均可评价疗效,其中CR 1例(5.3％),PR 10例(52.6％),SD 5例(26.3％),PD 3例(15.8％),总有效率57.9％,中位TTP为5.8个月,中位OS为10.5个月;常见不良反应为骨髓抑制、胃肠道反应、外周神经毒性、脱发且多以Ⅰ-Ⅱ度为主.结论:多西他赛联合奥沙利铂、卡培他滨方案治疗晚期胃癌近期疗效好,不良反应可耐受.     

卡培他滨联合顺铂治疗晚期胃癌临床疗效观察

目的:观察卡培他滨(希罗达)联合顺铂治疗晚期胃癌的疗效及不良反应.方法:采用口服卡培他滨1000mg/m2,每天2次,第1-14天,顺铂30mg/m2,静脉滴注,第1-3天,21天为1周期,连用2周期以后评价疗效.结果:28 例晚期胃癌患者均可评价疗效,总有效率RR为53.6%, 其中CR 2例(7.1%),PR 13例(46.4%),SD 6例(21.4%),PD 7 例(25.0%).不良反应为胃肠道反应Ⅰ-Ⅱ度,手足综合征Ⅰ-Ⅱ度.结论:卡培他滨联合顺铂治疗晚期胃癌近期疗效较好,不良反应较小,患者耐受 性高,可改善患者的生存质量.     

吉西他滨联合铂类治疗64例晚期非小细胞肺癌临床疗效研究

目的:比较吉西他滨(gemcitabine)联合顺铂(cisplatin)、卡铂(carboplatin)和奥沙利铂(oxaliplatin)三种化疗方案对晚期非小细胞肺癌(NSCLC)的疗效和毒性反应。方法:经病理和细胞学证实的64例晚期NSCLC患者随机分为吉西他滨 顺铂(gemcitabine cisplatin,Gcis)、吉西他滨 卡铂(gemcitabine carbopl-atin,Gcarb)和吉西他滨 奥沙利铂(gemcitabine oxaliplatin,GLOHP)三组。三组均选用吉西他滨1000mg/m2静脉滴注第1、8天。GCis组:顺铂70mg/m2静脉滴注,第1天;GCarb组:卡铂AUC4～6(初治6,复治4～5),静脉滴注,第1天;GLOHP组:奥沙利铂LOHP130mg/m2静脉滴注,第1天。三组均21天为一周期,连续使用2～3周期评价疗效和毒副反应。结果:Gcis、Gcarb、GLOHP三种方案治疗晚期非小细胞肺癌的有效率分别为52.38%(11/21)、50.00%(10/20)和60.87%(14/23)(P>0.05)。三种方案毒副反应主要为可耐受的骨髓抑制、消化道反应、脱发和外周神经毒性等。结论:吉西他滨联合三种不同铂类的化疗方案均为治疗晚期非小细胞肺癌较为安全有效的化疗方案。     

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.     

奥沙利铂联合卡培他滨治疗转移性胃腺癌的临床研究

目的:观察奥沙利铂联合卡培他滨(XELOX)方案一线治疗转移性胃癌的疗效及安全性。方法:2004年1月-2007年6月西安交通大学医学院第一附属医院肿瘤外科收治的、经组织学证实的转移性胃腺癌患者54例,接受XELOX方案化疗,奥沙利铂130 mg/m2,静脉滴注4h,第1天;卡培他滨1000 mg/m2,口服2次/天,第1-14天,每3周重复一次,每2周期后进行疗效评估。结果:54例接受XELOX方案一线治疗的患者均可评价疗效,CR 4例,PR 24例,SD 18例,PD 8例,总有效率为51.8%,临床获益率为85.1%,中位肿瘤进展时间6.0月,中位生存时间12.1月,1年生存率35.1%;XELOX方案治疗发生Ⅲ-Ⅳ级不良反应,其中神经毒性、血液学毒性和消化系统毒性各4例,手足综合征5例。结论:XELOX方案作为一线治疗晚期转移性胃癌疗效肯定,安全性高,不良反应轻,患者耐受性好。     

伊立替康或奥沙利铂联合卡培他滨治疗晚期胃癌的疗效比较

目的 观察并比较伊立替康(CPT-11)联合卡培他滨(CAP)与奥沙利铂(L-OHP)联合CAP治疗晚期胃癌的近期疗效和毒副反应.方法 将63例晚期胃癌患者随机分为两组,CPT-11+CAP组32例,应用CPT-11联合CAP方案治疗;L-OHP+CAP组31例,应用L-OHP联合CAP方案治疗.2个周期后评价疗效及毒副反应,有效病例4周后进行疗效确认.结果 CPT-11+CAP组PR 13例,有效率为40.6%,中位无进展生存期为6.3个月.L-OHP+CAP组PR 12例,有效率为38.7%,中位无进展生存期为6.1个月.两组有效率及中位无进展生存期比较,差异均无统计学意义(P＞0.05).两组的主要毒副反应为胃肠道反应、周围神经毒性和骨髓抑制.CPT-11+CAP组Ⅲ、Ⅳ度腹泻的发生率(28.1%)高于L-OHP+CAP组(3.2%,P=0.018),Ⅲ、Ⅳ度周围神经毒性的发生率(3.1%)低于L-OHP+CAP组(25.8%,P=0.027).两组均无化疗相关性死亡.结论 CPT-11联合CAP方案与L-OHP联合CAP方案对晚期胃癌均有较好的疗效,毒副反应均可耐受.

Abstract：

Objective To observe and compare the response rate and toxicity of irinotecan or oxaliplatin combined with capecitabine in the treatment of advanced gastric cancer.Methods Sixty-three patients with advanced gastric cancer were randomly divided into two groups.The CPT-11 + CAP group consisted of 32 patients who received irinotecan plus capocitabine: CPT-11 100 mg/m2 was injected in 90 minutes on d 1,8 ;capecitabine 2000 mg/m2, bid, with the first dose in the evening of day 1 and last dose the morning of day 15, repoated for every 21 days.The L-OHP + CAP group consisted of 31 patients who received oxaliplatin plus capecitabine: oxaliplatin 100 mg/m2 on day 1, capocitabine 2000 mg/m2, bid,with the first dose in the evening of day 1 and last dose the morning of day 15, repeated for every 21 days.Two or more cycle chemotherapy was completed in each group.Results In the CPT-11 + CAP group, no patient achieved complete response and 13 patients achieved partial response.The overall response rate was 40.6% (13/32), and the median progression-free survival time was 6.3 months.In the L-OHP + CAP group, no patient achieved complete response and 12 patients achieved partial response.The overall response rate was 38.7% (12./31), and the median progression-free survival time was 6.1 months.There was no significant difference between them (P ＞ 0.05 ).The most common toxicities were gastrointestinal reaction,peripheral neuropathy and myelosuppression in the two groups.Patients in CPT-11 + CAP group experienced more Ⅲ/Ⅳ diarrhea (28.1%/3.2%, P =0.018).On the contrary, the rate of Ⅲ/Ⅳ neurotoxicity in the group B was higher (25.8%/3.1%, P = 0.027).No chemotherapy-related death occurred.Conclusion The therapeutic effects of irinotecan or oxaliplatin combined with capecitabine in the treatment of advanced gastric cancer are good and comparable, and their toxicities are tolerable.     

奥沙利铂联合卡培他滨治疗转移性胃腺癌的临床研究

目的：观察奥沙利铂联合卡培他滨（XELOX）方案一线治疗转移性胃癌的疗效及安全性。方法：2004年1月-2007年6月西安交通大学医学院第一附属医院肿瘤外科收治的、经组织学证实的转移性胃腺癌患者54例,接受XELOX方案化疗,奥沙利铂130 mg/m2,静脉滴注4h,第1天;卡培他滨1000 mg/m2,口服2次/天,第1-14天,每3周重复一次,每2周期后进行疗效评估。结果：54例接受XELOX方案一线治疗的患者均可评价疗效,CR 4例,PR 24例,SD 18例,PD 8例,总有效率为51.8%,临床获益率为85.1%,中位肿瘤进展时间6.0月,中位生存时间12.1月,1年生存率35.1%;XELOX方案治疗发生Ⅲ-Ⅳ级不良反应,其中神经毒性、血液学毒性和消化系统毒性各4例,手足综合征5例。结论：XELOX方案作为一线治疗晚期转移性胃癌疗效肯定,安全性高,不良反应轻,患者耐受性好。     

奥沙利铂联合卡培他滨治疗晚期胃癌的临床观察

目的 评价奥沙利铂联合卡培他滨（XELOX）方案治疗晚期胃癌的疗效和不良反应。方法56例晚期胃癌患者予奥沙利铂130mg／m^2,第1天,静脉滴注;卡培他滨1000mg／m^2每天口服2次,第1～14天,21天为1个周期。至少治疗2周期评价疗效。结果CR0例,PR27例,SD13例,PD16例,总有效率为48．2％,疾病控制率（DCR）为71．4％。其中初治组总有效率为60．0％,明显高于复治组的34．6％（P〈0．05）。不良反应主要为骨髓抑制、恶心呕吐、神经毒性。结论XELOX方案治疗晚期胃癌疗效肯定,安全性好,不良反应可耐受,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

Objective: The aim of this study was to evaluate the response rate, time to progression (TTP), overall survival, and safety of the combination of capecitabine plus oxaliplatin in treatment of advanced gastric cancer (AGC). Methods: All the patients with advanced gastric cancer who were not received any prior chemotherapy or radiotherapy were treated with combination of capecitabine (1250 mg/m2 twice daily, days 1-14) plus oxaliplatin (130 mg/m2 as a 2-h intravenous infusion on day 1) every 3 weeks. Results: Two cases of complete response (CR) and 34 cases of partial response (PR) were confirmed, giving an overall response rate of 52.9%, of the 68 patients with advanced gastric cancer. The median TTP and overall survival for all patients were 7.3 and 11.9 months, respectively. Grade 3 leukopenia, thrembocytopenia, nausealvomiting, and diarrhea were observed in 3, 5, 1, and 4 patients, respectively. Yet, no grade 4 toxicity was observed. Conclusion: Capecitabine/ oxaliplatin combination chemotherapy is active in patients with advanced gastric cancer.     

表柔比星联合奥沙利铂与卡培他滨方案治疗晚期胃癌的临床观察

目的：探讨EOX化疗方案（表柔比星＋奥沙利铂＋卡培他滨）治疗晚期胃癌的临床疗效及毒副反应.方法：经病理学证实的晚期胃癌共23例,采用EOX方案化疗：表柔比星50mg/m2,d1;奥沙利铂130mg/m2静脉滴注,d1;卡培他滨1250mg/m2,每天分2次口服,d1-14,3周为1个周期,完成6个周期或直至肿瘤进展或毒副反应无法耐受即治疗停止.每2周期评价疗效及毒副反应.结果：23例均可评价疗效.CR 1例,PR 10例,SD 6例,PD 6例,总有效率（RR）为47.8％,疾病控制率（DCR）为73.9％.中位疾病无进展时间（mPFS）6.4个月,中位总生存期（mOS） 10.6个月,1年生存率为43.5％.其中初治患者总有效率（RR）为56.2％,中位疾病无进展时间（mPFS） 7.1个月,中位总生存期11.2个月.毒副反应主要为血液学毒性及胃肠道反应,手足综合症发生率不高.结论：EOX方案治疗晚期胃癌有较高的有效率,患者耐受性良好,生活质量高,是较理想的晚期胃癌一线治疗方案.     

伊立替康联合卡培他滨治疗晚期结直肠癌的临床观察

目的：观察伊立替康（CPT-11）联合卡培他滨（Capecitabine，希罗达）治疗晚期结直肠癌的疗效及毒性反应。方法：从2004年2月-2006年5月对晚期结直肠癌采用CPT-11联合卡培他滨方案化疗。入组患者均经病理组织学证实，且有可测量病灶。具体方案为：CPT-11250mg／m^2 iv，d1；希罗达1250mg／m^2 po，bid，d1-d14。21天为1个周期，化疗2个周期后评价疗效及毒性反应。结果：可评价疗效者60例，其中完全缓解（CR）4例，部分缓解（PR）22例，有效率（RR）为43．3％，稳定（SD）28例（46．7％），进展（PD）6例（10．0％）。临床受益率为83．3％，疼痛缓解率83．3％。肿瘤中位进展时间7．2个月，中位生存期13．8个月。主要毒副反应为迟发性腹泻和中性粒细胞减少，未出现治疗相关性死亡。结论：CPT-11联合卡培他滨方案治疗晚期结直肠癌患者有较好疗效，毒副反应可以接受。     

周剂量多西紫杉醇联合卡培他滨治疗晚期胃癌的临床观察

目的观察周剂量多西他赛联合卡培他滨治疗晚期胃癌的近期疗效和不良反应。方法 37例晚期胃癌患者采用多西他赛35mg/m2,静脉滴注,第1,8天;卡培他滨1250mg/m2,bid,口服,1～14d,21d为1周期。3周期后评价疗效和不良反应。结果全组37例患者均可评价疗效,其中CR3例（8.1%）,PR19例（51.3%）,SD10例（27.0%）,PD5例（13.5%）,总有效率59.5%。中性粒细胞减少发生率54.0%。中位TTP为6.5个月（3.2～11.5个月）,中位MST为10.3个月（5.8～14.7个月）。结论多西他赛联合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。     

Second-Line Capecitabine and Oxaliplatin Combination for Gemcitabine-Resistant Advanced Pancreatic Cancer

Background: The role of second-line therapy in metastatic pancreatic cancer is not clear. In this study, we aimed to explore the second-line efficiency of capecitabine and oxaliplatin (XELOX) in patients with advanced pancreatic cancer who have received gemcitabine-based first-line therapy. Materials and Methods: We retrospectively evaluated 47 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine-based first-line regimens. Treatment consisted of oxaliplatin 130 mg/m2 and capecitabine 1000 mg/m2 twice daily with a 3 week interval, until unacceptable toxicity or disease progression. Results: Median number of cycles was 4 (range, 2-10). The overall disease control rate was 38.3%. The median overall survival and progression-free survival from the start of second-line therapy were 23 weeks (95%CI: 16.6-29.5 weeks) and 12 weeks (95%CI: 9.8-14.4 weeks), respectively. The most common grade 3-4 toxicities were nausea, vomiting and hematologic side effects. Conclusions: Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with ECOG performance status 0-2.     

Phase II trial of capecitabine/irinotecan and capecitabine/oxaliplatin in advanced gastrointestinal cancers

Combination protocols of 5-fluorouracil/leucovorin (5-FU/LV) plus irinotecan or oxaliplatin have demonstrated high activity in metastatic colorectal cancer. Capecitabine, an oral 5-FU prodrug, may replace infusional 5-FU/LV in combination protocols with irinotecan or oxaliplatin. We therefore initiated a phase II study with capecitabine plus either irinotecan or oxaliplatin to determine the efficacy and toxicity of specific combination protocols in patients with advanced gastrointestinal (GI) tumors. Capecitabine 1000 mg/m(2) taken orally twice a day on days 1-14, plus oxaliplatin 70 mg/m(2) on days 1 and 8, or irinotecan 100 mg/m(2) on days 1 and 8; repeated every 3 weeks in an outpatient setting. Patient and tumor characteristics were as follows: median age, 68 years (range, 34-77 years); sex: 10 women, 33 men; tumor types: 35 colorectal cancer; 8 other GI tumors including 5 gastric, 2 pancreatic, and 1 duodenal cancer. All 43 patients treated were evaluable for toxicity (capecitabine/oxaliplatin, 24 patients; capecitabine/irinotecan, 19 patients), and 39 were evaluable for efficacy (capecitabine/oxaliplatin, 22; capecitabine/irinotecan, 17). Grade 3/4 toxicities (National Cancer Institute Common Toxicity Criteria Version 2.0) were limited to diarrhea, 9 patients (capecitabine/irinotecan, n = 5; capecitabine/oxaliplatin, n = 4); hand-foot syndrome, 1 patient (capecitabine/irinotecan); nausea, 2 patients (capecitabine/oxaliplatin); vomiting, 1 patient (capecitabine/oxaliplatin); and peripheral neuropathy, 1 patient (capecitabine/oxaliplatin). No grade 3/4 myelosuppression was noted for either protocol. Capecitabine/irinotecan and capecitabine/oxaliplatin demonstrated significant clinical activity in colorectal cancer and other GI cancers as first-line and salvage therapy. Capecitabine/oxaliplatin and capecitabine/irinotecan show an excellent safety profile and clinical activity in colorectal cancer and other advanced GI tumors. The main toxicity in both arms was manageable diarrhea. This trial served as basis for a randomized multicenter phase II study comparing capecitabine/oxaliplatin and capecitabine/irinotecan as first-line therapy in patients with advanced colorectal cancer.