卡培他滨联合伊立替康二线治疗晚期胰腺癌的临床研究

目的:观察卡培他滨联合伊立替康方案二线治疗晚期胰腺癌的疗效和毒性反应。方法:16例既往接受过基于吉西他滨的方案化疗失败的胰腺癌患者,给予卡培他滨1 000 mg/m2口服,2次/d,第1-14天;伊立替康150 mg/m2,静脉滴注,第1天,每4周重复。完成2个周期及以上评价。结果:16例患者中无达到完全缓解及部分缓解者,9例(56.3%)病情稳定,7例(43.8%)病情进展,疾病控制率56.3%;临床获益率31.2%;中位无进展生存12周;中位生存期4个月;血液学毒性发生率75%,其中3～4度白细胞下降的发生率16.7%,3～4度血小板下降发生率16.7%;腹泻发生率41.7%。1例出现3度腹泻,恶心、呕吐发生率50%,无化疗相关死亡。结论:卡培他滨联合伊立替康方案用于吉西他滨方案化疗失败的晚期胰腺癌总体临床耐受性好,可以改善患者生活质量,主要不良反应是血液学毒性和腹泻。

Clinical study of capecitabine combined with irinotecan as second-line chemotherapy for advanced pancreatic cancer

Objective To evaluate the efficacy and toxicity of capecitabine combined with Irinotecan as second-line treatment for advanced pancreatic cancer.Method 16 failure pancreatic cancer patients received chemotherapy based on gemcitabine scheme were given capecitabine 1 000 mg/m2 orally,two twice a day for 1-14 days;150 mg/m2,iv,Irinotecan-based,repeating every four weeks.Completed two cycle with corresponding evaluation.Results Among 16 patients who got complete remission(CR) and part com partial remission(PR),9 cases(56.3%) were in stable condition and 7 patients were(43.8%) progressed,control rate was 56.3%,clinical benefit rate was 31.2%,the median progression-free survival was 12 weeks;A median survival time was 4 months,Hematology toxic rate was 75%.(declining rate of the 3-4 degrees white blood cells was16.7%,declining rate of the 3-4 degrees platelet was 16.7%),diarrhea rate was 41.7%(1 case of third-degree diarrhea),nausea vomiting rate was 50%,without chemotherapy related death.Conclusion As for its good general clinical tolerance,capecitabine joint Irinotecan-based scheme is good for those patients who have received failed gemcitabine scheme for advanced pancreatic cancer chemotherapy.It can improve the quality of life of the patients.The major adverse reaction is hematology toxicity and diarrhea.