卡培他滨治疗晚期肿瘤的疗效及所致手足综合征的临床处理

目的评价卡培他滨治疗晚期肿瘤和大剂量VitB6防治卡培他滨所致手足综合征的疗效。方法2003年3月~2007年9月收治晚期乳腺癌、胃肠肿瘤及头颈部鳞癌52例。所有病人均予卡培他滨2500mg/m2/d,连服l4d,间歇7d,3w为1个周期并随机分为同时应用大剂量VitB6组（300mg/d）和对照组。结果1例完全缓解,15例部分缓解,14例病情稳定;客观缓解率为30.77%,临床获益率为57.69%。常见毒性反应中,手足综合征发生率对照组为65.38%,治疗组53.85%,其中Ⅱ＋Ⅲ级对照组53.85%,治疗组21.74%。结论卡培他滨治疗晚期乳腺癌、结直肠肿瘤及头颈部鳞癌安全、有效。其常见毒副反应手足综合征经大剂量VitB预防处理后,Ⅱ＋Ⅲ级发生率明显下降。

Study on the therapeutic effect of capecitabine on advanced carcinoma and treatment of hand-foot syndrome induced by capecitabine

Objective To evaluate the efficacy of capecitabine in patients with advanced carcinoma and of high - dose vitamin B6 in treatment of hand - foot syndrome induced by capetitabine. Methods fifty - two patients with advanced breast/colorectal/head and neck carcinoma admitted from March 2003 to Septmber 2007 were enrolled. Capecitabine was given in a dose of （total） 2 500mg/m2 twice a day for days with on interval of 7 days. 3 weeks as a treatment course. These patients were randomly divided into two groups, combina- tion of oral high -dose vitamin B6（300mg/day） with capetitabine was given in one group and the other group merely received capeti- tabine as control. Results Among these patients, the overall response rate was 30.77% with 1 CR and 15 PR,SD was 14. And the clinical benefit reaponse rate was 57.69%. Among common adverse reactions, the rate of hand - foot syndrome in control group was 65. 38% ,and in the concomitant high- dose vitamin B6 group was 53.85% ;the rate of grade Ⅱ/Ⅲ hand - foot syndrome in the control group was 53.85% ,and in vitamin B6 - group was 21.74%. Conclusions Capecitabine is effective and well - tolerated oral chemother- apy for advanced patients with pretreated metastatic breast/colorectal/head and neck carcinoma. High - dose vitamin B6 can lower the rate of Ⅱ ＋ Ⅲ grade of hand - foot syndrome induced by Capecitabine.