单药沙利度胺治疗晚期软组织肉瘤的临床疗效观察  

Thalidomide Monotherapy in Patients with Advanced Soft Tissue Sarcoma

作　　者：蔡铭泉[1] 李晓虹[1] 张映红[1] 吕晓君[1] 

机构地区：[1]厦门大学附属第一医院肿瘤内科,福建省厦门市361001

出　　处：《中国全科医学》2013年第8期930-932,共3页Chinese General Practice

摘　　要：目的评价沙利度胺单药治疗晚期软组织肉瘤的疗效、毒副作用及其对患者生活质量的影响。方法选择我院22例经二线方案化疗失败的晚期软组织肉瘤患者,口服沙利度胺治疗,100 mg/d,晚睡前顿服,1周后加量至200 mg/d,维持治疗至疾病进展,同时口服阿司匹林75 mg/d。根据实体瘤疗效评价标准(RECIST标准)评价疗效,按NCI-CTC 3.0标准评价毒副作用,参照Karnofsky评分评价患者生活质量。结果 (1)22例患者治疗后,无完全缓解(CR)者、部分缓解(PR)2例、疾病稳定(SD)4例、疾病进展(PD)16例,疾病控制率(DCR)为27%(6/22),2例PR患者缓解时间为6～13个月,4例SD患者稳定时间为3～6个月,所有患者中位无进展生存时间为1个月、总生存时间为5个月。(2)22例患者治疗后,无生活质量显著改善者、改善3例、稳定5例、下降14例。(3)22例患者口服沙利度胺1～13个月,无治疗相关死亡,主要毒副作用为疲乏、嗜睡、便秘、口干,Ⅰ～Ⅱ级占82%,经对症治疗后,可继续原剂量治疗。1例患者出现Ⅲ～Ⅳ级便秘,经甘油灌肠后缓解;3例患者出现Ⅲ～Ⅳ级嗜睡,经沙利度胺减量50 mg/d后,症状缓解。结论单药沙利度胺治疗软组织肉瘤具有一定疗效,可提高患者生活质量。Objective To evaluate thalidomide monotherapy in advanced soft tissue sarcoma(ASTS)and its impact on quality of life(QOL).Methods Twenty-two ASTS patients having failed in second-line chemotherapy were given thalidomide,100 mg/d and up to 200 mg/d after a week,and oral aspirin,75 mg/d.The treatment was maintained till disease progression.Results After treatment,0 patient had complete recovery(CR),2 partial recovery(PR),4 stable disease(SD),16 progressing disease(PD),and the disease control rate(DCR)was 27%(6/22).The remission time of 2 PR patients was 6~13 months,that of 4 SD was 3~6 months.The mean progression-free time of all patients was 1 month,total survival time was 5 months.No patients had remarkable QOL improvement,3 had improvement,5 stable QOL,14 had decrease.After 1~13 months of oral thalidomide,no therapy-related death occurred,the main side effects were fatigue,drowsiness,constipation,dry mouth,GradesⅠ~Ⅱaccounting for 82%.One had gradesⅢ~Ⅳconstipation and remitted after glycerin enema;3 had gradesⅢ~Ⅳlethargy and remitted after 50 mg/d reduction of thalidomide.Conclusion Thalidomide monotherapy in third-line ASTS treatment can elevate patients' QOL,and its side effects is tolerable.

关 键 词：沙利度胺 肉瘤 药物疗法 治疗结果 

分 类 号：R739.9[医药卫生—肿瘤]