卡培他滨单药或联合方案治疗晚期胃癌的临床研究

目的 探讨卡培他滨单药或联合方案治疗晚期胃癌的疗效及安全性.方法 104例晚期胃癌患者接受如下方案治疗:(1)卡培他滨单药组:卡培他滨1000 mg/m2,口服,2次/d,第1～14天,21 d为1个周期.(2)卡培他滨+紫杉类组:卡培他滨1000 ms/m2,口服,2次/d,第1～14天;紫杉醇175 ms/m2,静脉滴注,第1天(或80～90 ms/m2,静脉滴注,第1、8天);或多西紫杉醇65～75mg/m2,静脉滴注,第1天;21 d为1个周期;(3)卡培他滨+铂类组:卡培他滨1000 ms/m2,口服,2 次/d,第1～14天;顺铂15～20 ms/m2,避光静脉滴注2 h,第1～5天;或奥沙利铂130 mg/m2,静脉滴注2 h,第1天;21 d为1个周期.中位治疗3个周期.结果 104例患者的总客观有效率为20.6%,中位生存时间为8.5个月,中位疾病进展时间为5.2个月.在可评价疗效的患者中,一线治疗的客观有效率为40.0%,疾病控制率为76.7%.卡培他滨+紫杉类化疗组的总中位生存期为10.9个月,一线治疗的中位生存期为12.8个月.卡培他滨单药组的不良反应发生率最低.结论 以卡培他滨为基础的治疗方案疗效尚可,患者耐受性好,单药治疗适用于KPS评分<80分的患者,联合紫杉类化疗组的患者生存时间略长,但尚需进一步验证.

Retrospective study on regimens of capecitabine-based chemotherapy in the treatment for advanced gastric cancer

Objective To evaluate the toxicity and efficacy of capecitabine-based chemotherapy in the treatment of advanced gastric cancer. Methods 104 patients with advanced gastric cancers were treated with capeeitabine-based chemotherapy regimens from Sept. 2001 to May 2007. Group 1 was treated by capecitabine 1000 mg/m2 orally twice daily on D1-14, repeated every 3 weeks;group 2 by capecitabine as that of group 1, and combined with paclitaxel 175 mg/m2 intravenous infusion on D1 (or 80-90 mg/m2 on D1,D8),or docetaxel 65-75 mg/m2 on D1,repeated every 3 weeks; group 3 by capecitabine as that of group 1, combined with cisplatin 15-20 mg/m2 intravenous infusion for 2 h on D1-5,or oxaliplatin 130 mg/m<'2> for 2 h on D1, repeated every 3 weeks. The median cycles of treatment were 3 cycles. Results The overall response rate was 20.6%. The median overall survival and the median time to progression were 8.5 months and 5.2 months, respectively. For the first-line chemotherapy, ORR was 40.0%, disease control rate was 76.7%;the median overall survival in all patients and in the patients with first-line chemotherapy of capecitabine plus paelitaxel were 10.9 months and 12.8 months, respectively. The adverse events in capecitabine alone group were the least among all the groups. Conclusion The capecitabine-based chemotherapy was effective and tolerable. The patients with KPS<80 may choose eapecitabine alone for the chemotherapy. The regimen of capecitabine combined with paclitaxel was more effective than other regimens. However, further investigation to improve it is still required.