卡培他滨联合铂剂治疗晚期消化道恶性肿瘤的临床疗效观察

目的探讨卡培他滨联合铂剂治疗晚期消化道恶性肿瘤的临床疗效。方法选取72例2003年8月～2010年4月入本院治疗且确诊为晚期消化道恶性肿瘤的患者为研究对象,将其随机分为两组,每组36例,即卡培他滨与铂剂合用的联合治疗组和卡培他滨单用的单纯治疗组,通过口服分两次给予卡培他滨2500mg/(m.2d),连续使用两周,顺铂60～80mg.m-2,分三天静滴,对腹盆腔转移和肝转移的患者,一次性给予DDP腹腔灌注(与顺铂相同的用法,草酸铂130mg.m-2,卡铂300mg.m-2,一次性静滴),一个治疗周期约21～28天,持续化疗两个周期后评价两组患者的治疗疗效及不良反应的发生情况。结果联合治疗组治疗有效率为72.2%,而顺铂治疗组治疗有效率为52.7%,联合治疗组治疗有效率显著高于顺铂治疗组(P<0.05);联合治疗组生活质量的改善率为69.4%,显著高于顺铂治疗组(44.4%,P<0.05);此外,联合治疗组恶心呕吐、腹泻、黏膜炎、手足综合症不良反应的发生率均显著低于顺铂治疗组(P<0.05)。结论卡培他滨联合铂剂治疗晚期消化道恶性肿瘤的临床效果较单用顺铂好,且不良反应的发生率更低,值得在晚期消化道恶性肿瘤的治疗中推广和应用。

Clinical Observation on Therapeutic Effect of Capecitabine Associated with Platinum Medicament on Advanced Gastrointestine Carcinoma

Objective To investigate the therapeutic effect of capecitabine associated with platinum medicament on advanced gastrointestine carcinoma.Methods 72 patients who were admitted in our hospital from August 2003 to April 2010 and finally diagnosed with advanced gastrointestine carcinoma were randomly divided into two groups,36 patients in each group,i.e therapeutic alliance group(capecitabine and platinum medicament) and single treatment group(only capecitabine).Capecitabine were given 2?500 mg/(m2·d),po,bid,for 2 weeks,cisplatin 60～80 mg·m-2,igtt,for 3 days.Patients with cavitas pelvis metastasis and liver metastasis were treated with DDP through perfusion of abdominal cavity one time(the same as cisplatin,oxaliplatin 130 mg·m-2,paraplatin 300 mg·m-2,igtt),one treatment cycle for 21～28 days.The therapeutic effect and incidence of adverse effects between the two groups were both compared after two treatment cycles.Results The effective rate of therapeutic alliance group was 72.2%,which was significantly higher than the single treatment group(52.7%,P<0.05),while the improvement rate of quality of life of therapeutic alliance group was 69.4%,which was significantly higher than the single treatment group(44.4%,P<0.05);moreover,the incidence of adverse effects such as nausea and vomiting,diarrhea,mucous membrane inflammation and hand-foot Syndrome of herapeutic alliance group were all markedly lower than that in the single treatment group(P<0.05).Conclusion The therapeutic effect of capecitabine associated with platinum medicament on advanced gastrointestine carcinoma was better than singly with capecitabine,and the incidence of adverse effects was lower,so it was worth being generalized and applied in clinic.